Critically ill children
Conditions
Interventions
Part I (only one group, no control):(1) The whole process was operated by two doctors or nurses who had obtained the qualification of China critical care ultrasound research group (ccusg)
(2) First, an operator placed the child in the supine position, raised the head of the bed by 30 °, and measured the CSA in the supine position according to the antral ultrasound measurement standard
(3) Then put the child in the right lateral decubitus position, measure the CSA of the right lateral decubitus position (keep the action unchanged after measurement), and another operator uses a syrin
Part II (observation group):Ultrasound was applied to monitor the gastric remnant, and the threshold was set at 50% of the last feeding amount
(1) If GRV < threshold, feeding volume or feeding speed c
(2) If there is a single GRV = threshold or other gastrointestinal symptoms, notify the doctor and follow the doctor's advice.
? If GRV = threshold but without gastrointestinal complications, the orig
? If GRV = threshold and accompanied by gastrointestinal complications, consider reducing the amount of feeding or suspending feeding, or changing the feeding mode or route, such as changing intermitt
Sponsors
Xianlan Zheng
Eligibility
Sex/Gender
All
Age
No minimum to 18 Years
Inclusion criteria
Inclusion criteria: 1 part I Inclusion criteria: (1) The age ranged from 1 month to 18 years; (2) Stay in PICU for >24 hours; (3) Children with gastric tube and enteral nutrition; (4) The children and / or family members gave informed consent and voluntarily participated in this study. (24 hours; (4) Pediatric critical illness score <80 points; (5) There were no contraindications to enteral nutrition, and enteral nutrition was performed 24-48 hours after admission to PICU; (6) The route of enteral nutrition is nasogastric tube; (7) The children and / or family members gave informed consent and voluntarily participated in this study. (<8-year-old children need the informed consent of their family members; = 8-year-old children need the informed consent of the children themselves and their family members.)
Exclusion criteria
Exclusion criteria: 1 part I Exclusion criteria: (1) Children with severe gastrointestinal disease, history of gastrointestinal surgery and other gastrointestinal function damage; (2) Children with severe abdominal distension, obesity, abdominal wall deformity, etc. who cannot undergo abdominal ultrasound examination; (3) Intracranial hemorrhage, spinal injury and other children who are not suitable for changing body position; (4) Children with infectious diseases. (5) Children with severe condition and need deep sedation who are not suitable for additional ultrasound examination; Exit criteria: (1) The child or family member requests to withdraw halfway; (2) The gastric contents can be seen under ultrasound, but after adjusting the angle and depth of the gastric tube, the patient still has incomplete retraction. 2 Part II Exclusion criteria: (1) Children with severe gastrointestinal disease, history of gastrointestinal surgery and other gastrointestinal function damage; (2) Children who used hormones or immunosuppressants for more than 3 months; (3) Children in the end stage of various diseases, such as advanced malignant tumors, cancer, etc; (4) Children with severe abdominal distension, obesity, abdominal wall deformity, etc. who cannot undergo abdominal ultrasound examination; (6) Intracranial hemorrhage, spinal injury and other children who are not suitable for changing body position; (7) Children with severe condition and need deep sedation who are not suitable for additional ultrasound examination; Children with infectious diseases.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| the supine cross-sectional area;right lateral decubitus cross-sectional area;Feeding amount reaching target time;Incidence of feeding interruption due to feeding intolerance; | — |
Secondary
| Measure | Time frame |
|---|---|
| Incidence of feeding intolerance;Albumin count;Length of hospitalization;Duration of mechanical ventilation; | — |
Countries
China
Contacts
Public ContactXianlan Zheng, Peng Liu
Children's Hospital of Chongqing Medical University
Outcome results
None listed