Predictive value of antral motility index for feeding intolerance in patients with enteral nutrition in ICU

Objective To investigate the application value of antral motility index(MI) monitored by bedside ultrasound in predicting feeding intolerance of enteral nutrition(EN) patients in ICU.

Methods A total of 82 EN patients through nasogastric tube were selected from ICU. The MI was measured by bedside ultrasound at 1 d, 2 d and 3 d of EN feeding, and the incidence of feeding intolerance was evaluated. The risk factors of FI occurrence were analyzed by logistics multiple-regression analysis, and the predictive value of MI to FI was analyzed by drawing ROC curve.

Results The incidence rates of FI in ICU patients at 1 d, 2 d and 3 d of EN were 20.7%(17/82), 24.4%(20/82) and 31.7%(26/82), respectively. The results of univariate analysis showed that the mechanical ventilation, enteral nutrition initiation time, sedative and analgesic drugs, MI and APACHEⅡ score were the influencing factors of FI(P < 0.05 to P < 0.01). The results of multivariate analysis showed that the mechanical ventilation, start time of enteral nutrition and MI were the independent influencing factors of FI(P < 0.05 to P < 0.01). The area under ROC curve, optimal cut-off value, sensitivity and specificity of MI for predicting FI were 0.856, 0.556, 0.765 and 0.782, respectively.

Conclusions The incidence of feeding intolerance is high in ICU patients. The mechanical ventilation, start time of enteral nutrition delaying and low MI are the high risk factors of feeding intolerance, and monitoring MI value can help to predict the occurrence of feeding intolerance.