The Effect of Abdominal Massage on the Gastric Residual Volume in Adult Patients Admitted in the Intensive Care Unit: A Randomized Controlled Trial

Providing optimal nutrition to critically ill ICU patients is crucial yet complex. Enteral feeding is preferred, but food intolerance, often indicated by elevated gastric residual volume, remains a major challenge, highlighting the importance of prevention and effective management as essential nursing responsibilities in critical care settings. Abdominal massage is a potential technique to enhance gastric motility, though evidence from ICU settings remains limited and inconsistent. This study aims to assess the effect of abdominal massage on gastric residual volume in adult ICU patients receiving nasogastric feeding.

A randomized controlled trial was conducted from January to June 2024 in the ICU of a tertiary care hospital in Lahore, Pakistan. Thirty-four eligible patients were allocated into intervention and control groups (n=17 each). The intervention group received 20-minute abdominal massage sessions twice daily, with an interval of two hours between each abdominal massage session, for three consecutive days. GRV was measured before the first and one hour after the second massage each day.

GRV decreased in the intervention group compared to the control group across all three days. On day one, mean GRV post-intervention was 96.17 ± 30.33 ml vs. 126.47 ± 39.83 ml (p=0.026); on day three, it was 85.00 ± 23.91 ml vs. 127.05 ± 38.97 ml (p <0.001). Within group comparisons showed statistically significant reductions on day two (p=0.010) and day three (p=0.003), but not on day one (p=0.174). However, ANOVA revealed that day-to-day reductions within the intervention group were not statistically significant (p=0.516).

The study demonstrated consistent GRV reduction with abdominal massage, supporting previous positive findings, though discrepancies with some studies may relate to differences in technique, duration, and patient profiles.

Abdominal massage may be an effective adjunct for reducing GRV in critically ill patients. Further large-scale studies are needed to validate its routine integration into ICU care.

Randomized controlled trial conducted in the intensive care unit (ICU), registered at clinicaltrials.gov with ID NCT06062381.