Effect of Swedish Abdominal Massage on Gastrointestinal Outcomes of Critical Ill Patients

The provision of adequate nutrition is a fundamental aspect of critical care management, aimed at supporting the recovery and healing processes of critically ill patients. Gastric intolerance is the central complication of gastrointestinal issues with enteral feeding in critically ill patients. It includes nausea, vomiting, diarrhea, excess gastric residual volume (GRV), abdominal distention, and constipation.[1] Several studies have suggested and described using the abdominal massage for patients in ICUs as a complementary therapy for improving gastrointestinal outcomes.[2] Hence, the present study aimed to determine the effectiveness of Swedish abdominal massage on gastrointestinal outcomes of critically ill patients. An experimental research study was conducted at the Intensive Care Unit of Saveetha Medical College with 30 critically ill patients receiving enteral feeding. Patients with continuous feeding, recent abdominal surgery, radiation therapy, gastrointestinal bleeding, spinal cord injury, intestinal blockage, ileus, diarrhea, or hemodynamic instability were excluded from the study. The outcomes of the study included GRV and abdominal discomfort. Swedish abdominal manual massage was administered to the study group for 20 minutes twice a day for five days after a pre-test assessment. Massage started on the patient's right side, and then the patient was turned onto their back with their knees bent and head tilted between 30 and 45 degrees in a state of relaxation. The massage movements followed nine steps along the abdominal wall, utilizing four major strokes: stroking, effleurage, kneading, and vibration. Post-assessment was done at the end of the intervention. Ethical principles were adhered to throughout the study. Data were analyzed using descriptive and inferential statistics. The results of the study indicated that the majority of the participants were female, with the mean age and BMI of the participants being 41 ± 9.5 years and 26.35 ± 3.2, respectively. The maximum GRV observed in the pre-test was 22.03 mL, which decreased to 13.05 mL in the post-test. The calculated paired t-values for GRV and abdominal discomfort were 11.705 and 8.731, respectively, which reveals that there was a statistically significant reduction in the levels of GRV and abdominal discomfort at P < 0.001. There was a positive moderate correlation between GRV and abdominal discomfort at P < 0.05, according to Karl Pearson's correlation. The findings of the current study are consistent with those of Howyda Ahmed et al., 2021, and Murhaf Aldugiem et al., 2021 who reported that abdominal massage was significantly effective in lowering GRV, preventing distension, and avoiding vomiting and constipation.[3,4] Additionally, Wang X et al.,[5] 2022, showed that abdominal massage reduces GRV, vomiting, abdominal distension, and VAP in adult critically ill patients, which is also in line with the present study findings. The study concluded that Swedish manual abdominal massage improved gastrointestinal outcomes and potentially better tolerance of enteral feeding. While the study's findings are promising, further research with larger sample sizes and controlled studies is needed to confirm the efficacy. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.