Absence Of Gastroesophageal Reflux Of Enteral Diet To Oropharynx On Patients Submitted To Respiratory Physiotherapy By Thoracic Vibro-Compression
Keywords:
physical therapy, gastroesophageal reflux, enteral nutrition, respiration artificial, pneumonia, aspiration, methylene blueAbstract
Objective
To evaluate whether the physiotherapeutic maneuver of thoracic vibro-compression causes gastroesophageal reflux of enteral diet into the oropharyngeal cavity in sedated adult patients with an artificial airway and requiring mechanical ventilation.
Methods
The sample consisted of 20 patients, fed an enteral diet through a tube placed in the stomach. A controlled cross-sectional study was carried out, in which the group of patients served as their own control. This same group was used in two moments: the experimental one, in which patients underwent physiotherapy consisting of thoracic vibro-compression; and the control moment, in which patients did not undergo the aforementioned maneuver. The methylene blue dye, commonly used as a marker in the hospital where the study was carried out, was used as a marker of gastric reflux in the enteral diet. time. At the end of each experiment, both in the control and experimental groups, three health professionals, without knowing which group each patient belonged to at the time, evaluated the color of the oropharyngeal cavity.
Results
In inspections of the patients' oropharyngeal cavity, none of them found evidence of the presence of the dye, placed in the enteral diet.
Conclusion
It is concluded that, in this group of patients, thoracic vibro-compression, as a respiratory physiotherapy maneuver, does not promote reflux of enteral diet into the oropharyngeal cavity.
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References
Akhtar TM, Street MK. Risk of aspiration with the laryngeal mask. Br J Anaesth 1994; 72:447-50.
Thompson R. Prevention of nosocomial pneumonia. Med Clin North Am 1994; 78: 1185-99.
Temple NJ. Nutrition and disease; challenges of research desing. Nutrition 2002; 18:343-47.
Woodcock NP, Zeigler D, Palmer D, Buckley P, Mitchell CJ, Macfie J. Enteral Versus Parenteral Nutrition: a pragmatic study. Nutriton 2001; 17: 1-12.
Carol LK , Keithley JK. Enteral Nutrition: potential complications and patient monitoring. Nurs Clin North Am 1989; 24 339-53.
Torres A, EI-Ebiary M, Sloer N, Montón C, Fábregas N. Stomach as a source of colonization of the respiratory tract during mechanical ventilation: association with ventilator-associated pneumonia. Eur Respir J 1996; 9: 1729-35.
Thompson-Henry S, Braddock B. The modified Evan's blue dye procedure fails to detect aspiration in the tracheostornized patient: five case reports. Dysphagia 1995; 10:172-74.
Metheny NA, Eisemberg P. Spies M. Aspiration pneumonia in patients fed through nasoenteral tubes. Heart Lung 1986; 15:256-61.
Metheny NA, Clouse RE. Bedside Methods for Detecting Aspiration in Tube Fed Patients. Chest 1997; 11:724-31.
Metheny NA , Spies M, Eisemberg P. Frequency of nasoenteral tube displacernent and associated risk factors. Res Nurs Health 1986; 9:241-47.
Potts R, Zaroukian M. Glucose content of tracheal aspirates. Crit Care Med 1995; 23:1451-52.
Montejo-Gonzales JC , Perez-Cardenas MD , Fernandez-Hermandez, AI. Detecting pulmonary aspiration of enteral feeding in intubated patients. Chest 1994; 106: 1632-3. [Letter)
Mikatti NE , Luthra AD , Healy TEJ . Mortimer AJ. Gastric regurgitation during general anaesthesia in different positions with the laryngeal rnask airway. Anaesthesia 1995; 50: 1053-55.
Bapat PP, Verghese C. Laryngeal mask airway and the incidence of regurgitation during gynecological laparoscopies. Anesth Analg 1997; 85:139-43.
Potts RG , Zaoroukian MH , G uerrero PA , Barker CD. Comparation of blue dye visualization and glucose oxidase test strip methods for detecting pulmonary aspiration of enteral feeding in intubated adults. Chest 1993; 103:117-21.
Mackenze CF. Fisioterapia respiratória em unidade de terapia intensiva. São Paulo: Panamericana; 1988. 288p.
Ceribelli MIPF. Suporte nutricional enteral e parenteral: pesquisa de enfermagem e aplicações em uma realidade [doutorado]. Ribeirão Preto: Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo; 1992.
Metheny NA, Eisemberg P, McSweeney M. Effect of feeding tube properties and three irrigants on clogging rates. Nurs Res 1988; 37: 165-69.
Marcaud SP, Perkins AM. Clogging of feeding tubes. J Parenter Enter Nutr 1988; 12:403-05.
lbánez J, Penafiel A, Raurich JM, Marse P, Jórda R, Mata F. Gastroesophageal reflux in intubated patients receiving enteral nutrition: affect of supine and semirecumbent positions. J Parenter Enter Nutr 1992; 16:419-22.
