2.50
Hdl Handle:
http://hdl.handle.net/10755/158973
Type:
Presentation
Title:
Relationship Between Hypoactive Bowel Sounds and Aspiration
Abstract:
Relationship Between Hypoactive Bowel Sounds and Aspiration
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2007
Author:Metheny, Norma, RN, PhD
P.I. Institution Name:St. Louis University
Contact Address:School of Nursing, St. Louis, MO, 63104, USA
Co-Authors:R.E. Clouse, School of Medicine, Washington University, St. Louis, MO and B.J. Stewart, School of Nursing, Oregon Health Science University, Portland, OR
Purpose: The study sought to determine the relationship between hypoactive bowel sounds and aspiration in patients receiving gastric feedings. Background: Hypoactive bowel sounds are viewed as an indication of poor tolerance to gastric feedings and a possible precursor to aspiration of gastric contents. However, the extent to which hypoactive bowel sounds are associated with aspiration is unknown. Subjects: A total of 90 adult critically ill, mechanically ventilated patients receiving continuous gastric feedings were included. Method: Patients were observed 16 hours per day for 3 consecutive days. At 4-hour intervals, assessments were made of bowel sounds (classified as either hypoactive or normal), use of prokinetics, volume of formula administered, gastric residual volume (GRV), and Glasgow Coma Scale (GCS) scores. Tracheobronchial aspiration of gastric contents was assessed by testing for pepsin in tracheal secretions obtained during routine suctioning. Pepsin-positive tracheal secretions (PPTS) were used as a proxy for aspiration of gastric contents. Results: The 25 patients with consistently normal bowel sounds tended to receive more formula than the 65 patients who had hypoactive bowel sounds at least once (mean 4-hour volumes were 175.6 ml versus 143.6 ml, respectively, p= .063). Prokinetics were used at least once in 31 of the 90 patients. A significant correlation (r =.25, p =.020) was found between the mean percent (+/- SD) of hypoactive bowel sounds (24.5 +/- 27.4%) and of PPTS (36.7 +/- 24.8%), when controlling for the effects of prokinetic use and volume of formula administered. Hypoactive bowel sounds were significantly correlated with mean GCS scores (r = -.33, p =.001) and mean GRVs (r =.41, p< .001). Three variables (dichotomous bowel sounds, dichotomized GCS score [<9 versus greater than or equal to 9], and mean GRV) were entered into a backward logistic regression to predict aspiration; only hypoactive bowel sounds (p = .013) and GCS score (p=.032) remained in the model. Conclusions: Hypoactive bowel sounds signal an increased risk for aspiration during gastric feedings. A low level of consciousness likely increases aspiration risk by multiple mechanisms, including decreased bowel motility. Funded by NINR, R01 NRO5007
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleRelationship Between Hypoactive Bowel Sounds and Aspirationen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158973-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Relationship Between Hypoactive Bowel Sounds and Aspiration</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Metheny, Norma, RN, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">St. Louis University</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">School of Nursing, St. Louis, MO, 63104, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">methenna@slu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">R.E. Clouse, School of Medicine, Washington University, St. Louis, MO and B.J. Stewart, School of Nursing, Oregon Health Science University, Portland, OR</td></tr><tr><td colspan="2" class="item-abstract"> Purpose: The study sought to determine the relationship between hypoactive bowel sounds and aspiration in patients receiving gastric feedings. Background: Hypoactive bowel sounds are viewed as an indication of poor tolerance to gastric feedings and a possible precursor to aspiration of gastric contents. However, the extent to which hypoactive bowel sounds are associated with aspiration is unknown. Subjects: A total of 90 adult critically ill, mechanically ventilated patients receiving continuous gastric feedings were included. Method: Patients were observed 16 hours per day for 3 consecutive days. At 4-hour intervals, assessments were made of bowel sounds (classified as either hypoactive or normal), use of prokinetics, volume of formula administered, gastric residual volume (GRV), and Glasgow Coma Scale (GCS) scores. Tracheobronchial aspiration of gastric contents was assessed by testing for pepsin in tracheal secretions obtained during routine suctioning. Pepsin-positive tracheal secretions (PPTS) were used as a proxy for aspiration of gastric contents. Results: The 25 patients with consistently normal bowel sounds tended to receive more formula than the 65 patients who had hypoactive bowel sounds at least once (mean 4-hour volumes were 175.6 ml versus 143.6 ml, respectively, p= .063). Prokinetics were used at least once in 31 of the 90 patients. A significant correlation (r =.25, p =.020) was found between the mean percent (+/- SD) of hypoactive bowel sounds (24.5 +/- 27.4%) and of PPTS (36.7 +/- 24.8%), when controlling for the effects of prokinetic use and volume of formula administered. Hypoactive bowel sounds were significantly correlated with mean GCS scores (r = -.33, p =.001) and mean GRVs (r =.41, p&lt; .001). Three variables (dichotomous bowel sounds, dichotomized GCS score [&lt;9 versus greater than or equal to 9], and mean GRV) were entered into a backward logistic regression to predict aspiration; only hypoactive bowel sounds (p = .013) and GCS score (p=.032) remained in the model. Conclusions: Hypoactive bowel sounds signal an increased risk for aspiration during gastric feedings. A low level of consciousness likely increases aspiration risk by multiple mechanisms, including decreased bowel motility. Funded by NINR, R01 NRO5007</td></tr></table>en_GB
dc.date.available2011-10-26T21:34:43Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:34:43Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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