The applied research on the intra-abdominal pressure monitoring in early enteral nutrition in patients with severe pneumonia

摘要

Objective: To explore the applied value of intra-abdominal pressure (IAP) monitoring in early enteral nutrition (EEN) in patients with severe pneumonia. Methods: 96 patients with severe pneumonia who underwent EEN treatment in our hospital from June 2017 to June 2019 were selected. According to the random number table method, they were divided into a control group (48 patients) and an observation group (48 patients). The control group was treated using the conventional EN method, and the observation group was treated using the intra-abdominal pressure monitoring besides the conventional EN method. The incidence of EN intolerance, the acute physiology and chronic health evaluation (APECHEll) scores, the positive end expiratory pressure (PEEP) value, mechanical ventilation time, EN implementation days, length of stay in ICU, the incidence of ventilator-associated pneumonia, mortality, and the incidence of multiple organ dysfunction syndrome were compared between the two groups. Results: Compared with the control group, the incidence of EEN intolerance in the observation group was significantly reduced. The results of univariate analysis showed that, in the EN intolerance group, the IAP, the PEEP value and APACHEII scores after 3 days of EEN implementation were higher than the EEN tolerance group, indicating a influencing factor of EEN intolerance (P0.05). The results of multivariate analysis showed that IAP value was a risk factor for EEN intolerance (P0.05). The ROC curve analysis result for IAP to predict EEN tolerance showed that the area under the curve for IAP value to predict EN tolerance was 0.856, the optimal cut-off value was 10.73 mmHg, the sensitivity was 95.10%, and the specificity was 89.60%. Conclusion: The intra-abdominal pressure monitoring during the EEN in patients with severe pneumonia is a preferred method to guide the patients’ EEN.