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    Are Classic Bedside Exam Findings Required to Initiate Enteral Nutrition in Critically Ill Patients: Emphasis on Bowel Sounds and Abdominal Distension

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    Author
    Deane, AM; Ali Abdelhamid, Y; Plummer, MP; Fetterplace, K; Moore, C; Reintam Blaser, A
    Date
    2020-12-09
    Source Title
    Nutrition in Clinical Practice
    Publisher
    WILEY
    University of Melbourne Author/s
    Deane, Adam
    Affiliation
    Medicine and Radiology
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Deane, A. M., Ali Abdelhamid, Y., Plummer, M. P., Fetterplace, K., Moore, C. & Reintam Blaser, A. (2020). Are Classic Bedside Exam Findings Required to Initiate Enteral Nutrition in Critically Ill Patients: Emphasis on Bowel Sounds and Abdominal Distension. NUTRITION IN CLINICAL PRACTICE, https://doi.org/10.1002/ncp.10610.
    Access Status
    This item is embargoed and will be available on 2021-12-09
    URI
    http://hdl.handle.net/11343/257768
    DOI
    10.1002/ncp.10610
    Abstract
    The general physical examination of a patient is an axiom of critical care medicine, but evidence to support this practice remains sparse. Given the lack of evidence for a comprehensive physical examination of the entire patient on admission to the intensive care unit, which most clinicians consider an essential part of care, should clinicians continue the practice of a specialized gastrointestinal system physical examination when commencing enteral nutrition in critically ill patients? In this review of literature related to gastrointestinal system examination in critically ill patients, the focus is on gastrointestinal sounds and abdominal distension. There is a summary of what these physical features represent, an evaluation of the evidence regarding use of these physical features in patients after abdominal surgery, exploration of the rationale for and against using the physical findings in routine practice, and detail regarding what is known about each feature in critically ill patients. Based on the available evidence, it is recommended that an isolated symptom, sign, or bedside test does not provide meaningful information. However, it is submitted that a comprehensive physical assessment of the gastrointestinal system still has a role when initiating or administering enteral nutrition: specifically, when multiple features are present, clinicians should consider further investigation or intervention.

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