Effects of Abdominal Massage to Overcome Gastrointestinal Dysfunction in Patients in Intensive Care Unit: A Literature Review

Abstract

Patients who are receiving treatment at the ICU have at least one symptom of gastrointestinal dysfunction including decreased bowel noise, abdominal distension, constipation, decreased frequency of defecation, and increased GRV (gastric residual volume). Non-pharmacological interventions that can be done to improve gastrointestinal function include abdominal massage. This paper aimed to conduct a literature review on the effects of abdominal massage to overcome gastrointestinal dysfunction in patients in the ICU. Articles taken from the Google Scholar and Science Direct electronic databases with the keywords abdominal massage, gastrointestinal function, bowel function, and ICU were published from 2015 to 2019. There were four research articles discussing abdominal massage to improve gastrointestinal function. Three articles used the Randomized Controlled Design method and one article used the Quasi Experimental method. Abdominal massage has a positive effect to improve gastrointestinal function in patients receiving treatment in the ICU. Improved gastrointestinal function that can be seen from the existence of a faster time in the reduction in gastric residual volume (GRV), decreased abdominal circumference, decreased gastric distension, and decreased the incidence of constipation. It is expected that abdominal massage can be applied by ICU nurses considering this intervention has the effectiveness in terms of time and funding.Keywords: Abdominal Massage, Gastrointestinal Function, Intensive Care Unit

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“…This result agrees with the previous results of Fareed and Sayad (2017), Kahraman and Ozdemir (2015), Warren (2016) [9,12,29]. Also, the impact of massage in abdomen on decreasing abdominal distension in the present study may be caused by hasting peristalsis and blood-flow motions, stimulating the nutrients absorption, and facilitating the passage of nutritional components in the intestine, resulting in decreasing abdominal distension [16]. In addition, the current study displayed that occurrence of constipation was higher in the control group than the experimental group during the intervention period of abdomen massage.…”

“…Its effect may be owing to stimulating the parasympathetic division of the autonomic nervous system during various of compressive activities and encouraging rectal loading by increasing muscle activity and relaxing the sphincter in the gut and consequently increasing intra-abdominal pressure and improving peristalsis and bowel sensation resulting in increasing the gastric emptying and decreasing the residual volume. [16] In addition, it was clear that GRV was high in the control group than experimental group after intervention of abdomen massage. These results were similar to those of El-Feky and Ali (2020) and Momenfar et al, (2018).…”

“…Moreover, constipation is another form of gastric intolerance. Several studies have shown that 72% of patients in the ICU experience constipation due to MV after 72 hours and 40.5% were due to various types of nutritional therapy [16]. It can cause abdominal distension, feeding intolerance, vomiting, and can be associated with aspiration pneumonia.…”

“…It can cause abdominal distension, feeding intolerance, vomiting, and can be associated with aspiration pneumonia. In addition, constipation has been associated with worst outcomes, including increase in length of stay increased in ICU, duration of MV and even mortality rate [16]. In addition, vomiting is one of the major dangerous complications linked to enteral feeding via nasogastric tube as it perhaps increases the possibility for aspiration pneumonia [14].…”

“…Uysal et al (2012) indicated that abdominal massage is effective in prevention of high GRV, vomiting, abdominal distension, and constipation [22]. However, few research studies have been carried out to examine the effectiveness of abdomen massage intervention on the gastrointestinal clinical outcomes in critical ill patients who receive EN; consequently, there is a need for other studies (Uysal, 2017, Dehghan et al, 2018Kosasih et al, 2019) [23,7,16]. Hence, this study was carried out to evaluate the abdominal massage effect on gastrointestinal outcomes of critical ill patients with enteral feeding.…”