Left anterolateral thoracotomy with cross-clamping of the descending thoracic aorta and open cardiac massage to control massive intra-abdominal bleeding

Impact of abdominal massage on enteral nutrition complications in adult critically ill patients: A systematic review and meta-analysis

BACKGROUND

Adult critically ill patients are prone to complications when receiving enteral nutrition, including feeding intolerance. Although abdominal massage is an effective intervention, its effects on enteral nutrition complications in adult critically ill patients are controversial.

OBJECTIVE

To summarize and evaluate the effect of abdominal massage on enteral nutrition complications in adult critically ill patients.

METHODS

We searched databases (e.g., PubMed, the Cochrane Library, Embase, and Web of Science) from inception until November 2020 for relevant studies published in English. The methodological quality of selected studies was assessed with the Cochrane Risk of Bias 2.0 tool. And we used of PRISMA 2020 guidelines. The meta-analysis results were reported as mean difference (MD) and events, and the heterogeneity of the studies was evaluated using I².

RESULTS

Seven studies including 472 participants (aged≥18 years) met the inclusion criteria. The mean gastric residual volume (GRV) (MD=-42.41, 95% confidence interval [CI]: -71.43, -13.39; P = 0.004) and incidence of abdominal distension (odds ratio [OR]=0.08, 95%CI: 0.03, 0.19; P < 0.00001) were significantly lower in the massage therapy group compared with controls. The incidence of vomiting (OR=0.09, 95%CI: 0.01, 0.72; P = 0.02) and ventilator-associated pneumonia (VAP) (OR=0.20, 95%CI: 0.05, 0.77; P = 0.02) were statistically significantly lower in the abdominal massage group compared with controls.

CONCLUSION

Abdominal massage reduces GRV, vomiting, abdominal distension, and VAP in adult critically ill patients. Given the limited number of reviewed studies, small number of patients examined, and short intervention periods, further randomized controlled trials are needed that use accurate methodology, longer interventions, and larger sample sizes to confirm the effect of abdominal massage on feeding intolerance in adult critically ill patients.

Effects of abdominal massage on gastrointestinal function in ICU patients: a meta-analysis

Objective

To evaluate the effects of abdominal massage on gastrointestinal function in the intensive care unit (ICU) patients.

Methods

Randomized controlled trials about the effects of abdominal massage on gastrointestinal function in ICU patients were included from multiple electronic databases: PubMed, Web of Science, the Cochrane Library, Embase, CINAHL, China Academic Journals Full-Text Database (CNKI), Wanfang Database, and CQVIP, until November 2018. Studies were selected according to inclusion and exclusion criteria, extracting data and assessing. Data were analyzed by RevMan 5.3.

Results

Nine studies with 720 patients were included. The results of meta-analysis in the intervention group were as follows: abdomen circumference: mean difference (MD)=-4.22, 95% confidence interval (CI)=(-6.20, -2.24), P<0.00001; abdominal distension: MD=0.34, 95% CI=(0.22, 0.52), P<0.00001; gastric residual: MD=-41.51, 95% CI=(-55.86, -29.15), P=0.001; gastric retention: MD=-0.23, 95% CI (-0.30, -0.15), P<0.00001; and vomiting: MD=0.12, 95% CI=(0.04, 0.35), P=0.0001.

Conclusions

Abdominal massage is effective in reducing abdominal distension, gastric residual, and vomiting. When the intervention period was <7 days, abdominal massage could not reduce the abdominal circumference in ICU patients, and when the intervention period was equal to 7 days, abdominal massage could reduce the abdominal circumference in ICU patients.