Effectiveness of Intermittent Feeding Combined with Right Lateral Position on Gastric Residual Volume in Critically Ill Patients: A Randomized Controlled Study

Gastric residual volume is considered a monitoring parameter for impaired gastric emptying and enteral nutrition tolerance in ICU patients. Changing the body position to the right lateral position is regarded as an alternative approach that may accelerate gastric emptying. This study aimed to evaluate the effectiveness of enteral nutrition using the intermittent feeding method combined with the right lateral position on gastric residual volume in ICU patients.

This study was an open-label randomized controlled trial involving 52 ICU patients who were allocated to the control group (n=26) and the intervention group (n=26). The intervention group received enteral nutrition using intermittent feeding combined with the right lateral position, while the control group received standard care. The study was conducted from March 16 to June 14, 2024. Monitoring of gastric residual volume was conducted six times daily using an observation sheet, each time before the administration of enteral nutrition, for three consecutive days. The data were analyzed using statistical tests including frequency distribution, the Mann-Whitney U test, Spearman’s rank correlation, and linear regression.

The results showed no difference between enteral nutrition using the intermittent feeding method combined with the right lateral position and standard treatment in terms of gastric residual volume (Mean [SD]: 306.25 [302.94] mL vs 315.38 [342.16] mL; p = 0.927). Additionally, this study found that the administration of catecholamine drugs and blood potassium levels were significantly associated with gastric residual volume in the intervention group (p = 0.035 and p = 0.022, respectively).

Performing the right lateral position in ICU patients during intermittent feeding may serve as a strategy to reduce gastric residual volume, as indicated by the lower volume observed compared with the semi-recumbent position.

No statistically significant differences were found between the two groups regarding gastric residual volume. The use of catecholamines and potassium levels may be important factors to consider in determining enteral nutrition tolerance and the rate of gastric emptying. However, further studies with larger sample sizes are recommended to strengthen these findings.