P429 - A NEW EVALUATION OF GASTRIC TOLERANCE TO ENTERAL FEEDING USING SENSORS LOCATED ON THE NASOGASTRIC TUBE

P429

A NEW EVALUATION OF GASTRIC TOLERANCE TO ENTERAL FEEDING USING SENSORS LOCATED ON THE NASOGASTRIC TUBE

M. Hellerman Itzhaki^1,*, I. Kagan¹, A. Maman², P. Singer¹

¹Intensive Care, Rabin Medical Center, Beilinson Hospital, Petah Tikva, ²ARTMEDICAL, Natanya, Israel

Rationale: Gastric Residual Volume measurement does not evaluate properly gastric tolerance,  A new platform has been shown to improve feeding efficacy, modulate enteral feeding according to reflux detection (1). Our study aim was to retrospectively evaluate gastric tolerance using impedance sensors located on the nasogastric tube (NGT)

Methods: 45 patients from the smART study group were included. The presence of fluids on the lower (Z1 to Z4)  and /or the upper impedance sensors (Z5-Z6) was analysed in terms of duration (sec), fluid collected through the active residual release (ARR) to the bag. ARR was activated only if reflux remained more than 15 sec at the level of Z1-Z4 and/or if reflux reached Z5-Z6. If reflux was below 3 sec, it was not analysed.  If reflux and ARR were very elevated, parenteral nutrition (PN) was prescribed.

Results: 35 patients with a confirmed NGT in place were included. 20,000 reflux < 3 sec were eliminated. In 9,145 with Z1 to Z4 detections, duration of reflux  was 33 ± 161 sec and the weight of the ARR was low (1.2 ± 4.9 grs). In 4,865 with Z5 to Z6 detection, the duration of the reflux per event was 90 ± 345 sec and ARR reached 2.5 ± 6.0 g. Most of the events (90% and 75% for lower and upper detection respectively) had no significant weight in the bag. The total mean ARR was 54 ± 98 grs/d. Only 10% of the events were associated with ARR >240 grs. In 5 patients, PN was prescribed (209 ± 278 g/d) versus 117 ± 147 g/d in patients without PN.

Conclusion: The impedance sensors detect reflux and allow gastric release accordingly. This shed a new light on gastrointestinal intolerance during enteral feeding. A better understanding of these values may improve the efficacy of enteral medical nutritional therapy.

References: 1. Kagan I et al: Controlled enteral nutrition in critical care patients : A randomizedclinical trial of a novel management system. Clin Nutr 42 (2023) 1602-1609.

Disclosure of Interest: M. Hellerman Itzhaki: None declared, I. Kagan: None declared, A. Maman Other: ART Employe, P. Singer Consultant for: Medical Officer, Shareholder of: Limited stock options in respect of value commensurate with consultancy services for ART MEDICAL Ltd.