Studying the effect of abdominal massage on the gastric residual volume in patients hospitalized in intensive care units

Abstract Background The main problem of hospitalized patients in intensive care units is feeding, and if the patient does not receive the daily caloric intake required to his body, he will have malnutrition and problems related to it. Abdominal massage is a method used to improve digestive function in various studies, but few studies have been conducted in intensive care units, and sometimes, contradictory results have been obtained. Therefore, the present study is conducted with the aim of determining the effect of abdominal massage on the gastric residual volume in patients hospitalized in intensive care units. Methods This study was conducted as a clinical trial in Ahwaz, in 2017. Samples were 60 patients hospitalized in intensive care units who were randomly divided into case and control groups. The intervention period for the case group was 3 days and twice daily for 20 min. Measuring the gastric residual volume was investigated before the intervention and 1 hour after the second massage each day. Data were entered into the checklist designed by the researcher and were analyzed using SPSS version 24 and descriptive and inferential tests. Results The gastric residual volume on the second and third day after the intervention was less than before the intervention (p value 0.05). Conclusion Results represent the effect of abdominal massage on reducing the gastric residual volume in patients hospitalized in intensive care units. Therefore, it is suggested that this method can be considered as a caring method in the daily care program for these patients. Trial registration IRCT2017062134641N2, registered 26 July 2017

CORRELATION OF COMPUTED TOMOGRAPHY AND INTRAOPERATIVE FINDINGS WITH CLINICAL SYMPTOMS IN HEAD TRAUMA PATIENTS

Hematoma in different parts of the brain is one of the most important complications of head injury and is associated with high mortality and morbidity rate. The aim of this study was evaluation of the relationship between Computed Tomography (CT) and intraoperative findings with clinical symptoms in head trauma patients. In this study 95 patients with cerebral hemorrhage due to head trauma, referred to Taleghani Hospital in Kermanshah were studied. After an initial clinical examination, the level of consciousness determined according to the Glasgow Coma Scale (GCS) was recorded. All patients underwent brain CT scan and findings were recorded, including size and location of the hematoma. Patients in all treatment such as surgical procedures under the supervision, and the information on their status was recorded until discharge or death. It was found that most patients (38%) were between 40-20 years: 73% of patients were male, while 27% were female. The outcome of 35 patients (35.4%) were normal, 12 patients (12.3%) had moderate disability, 9 patients (9.2%) had severe disability, 11 patients (10.8%) vegetative state and 31 patients (32.3%) died. There was a significant association between location of the hematoma and hematoma in CT scan and outcome of patients with cerebral hemorrhage caused by trauma (P<0.05). We also found a significant association between size of the hematoma and midline shift in CT scan with outcome of patients with cerebral hemorrhage caused by trauma (P<0.05). The prognosis of patients with traumatic brain injury depends on location of the hematoma; volume of hematoma, midline shift in CT scan and length of trauma to surgery more than 4 hours

Transcutaneous Electrical Nerve Stimulation at the Acupuncture Points to Relieve Pain of Patients Under Mechanical Ventilation: A Randomized Controlled Study

Background and objective: Electrical stimulation and acupuncture points as nonpharmacological methods have been the focus of pain reduction in different patients. This study is aimed at determining the effects of transcutaneous electrical nerve stimulation (TENS) on the acupuncture points of pain in patients under mechanical ventilators. Materials and methods: This randomized double-blind clinical trial study was conducted on 50 patients undergoing mechanical ventilation in intensive care units of Imam Reza hospital in Kermanshah, Iran, in 2017. The patients were randomly allocated into intervention and placebo groups. In the intervention group, TENS electrodes were placed on points Hegu and Zusanli. Pain severity was measured using the Care Pain Observation Tool scale, and the dosages of narcotics and sedation intake were recorded. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 19. Results: The level of pain in patients decreased in the intervention group in comparison with the sham group, and this decline was significant during certain hours (p < 0.05). The amount of analgesic and sedation drugs used was less significant in the intervention group than in the sham group (p = 0.01; p = 0.04). Conclusion: The results showed that the use of TENS on acupuncture points can decrease the level of pain and opioid consumption in intubated patients under a mechanical ventilator. Keywords: acupuncture, Hegu, intensive care unit, pain management, Zusanl