Ultrasound meal accommodation test in critically ill patients with and without feeding intolerance UMAT-ICU

Gastrointestinal dysfunction (GID) is one of the leading causes of nonavoidable discontinuing or delayed enteral feeding in critically ill patients. The ultrasound meal accommodation test (UMAT) has been used in ambulatory patients to evaluate dyspepsia. The objective of this study was to determine differences in the UMAT scores of critically ill patients with and without feeding intolerance (FI).

A prospective, observational, two-centre study was conducted between June and August 2019. We included subjects who met the criteria for enteral nutrition. Patients and their subrogates provided signed consent for intervention. The independent variables were cross-sectional area (CSA) and calculated gastric volume (CGV). Dependent variables were changes in the UMAT at Time 1 and Time 2 and gastric residue in those with and without FI. After that, patients were divided into two groups, depending on the development of GID over the following 48 h after inclusion in the study group A, subjects without FI; and group B, subjects with FI. According to the normal distribution in parametric or non-parametric tests. Differences between groups were determined using a Student's T-test. A p-value of ≤0.05 was established for the statistical difference between groups. At 60 min, a change cut-off point of 52% has a sensitivity of 50%, specificity of 88.9%, a positive likelihood ratio of 4.50 and a negative likelihood ratio of 0.56. With a pretest probability of 85% for feeding tolerance in intensive care unit patients, the posttest probability increased to 96% with a positive test with the ΔCSA.

61 patients were included in the study; 52 (85%) in Group A and 9 (15%) in Group B. However, at time 0 (fasting), there were statistical differences in CSA and CGV between groups (p = 0.001). During Time 1 (dynamic changes), there were statistical differences between the groups (p = 0.008 for CSA and p = 0.011 for CGV). At time 3 (Delta), there were statistical differences between groups at minute 10 (p = 0.023 for CSA and p = 0.008 for CGV).

Our study showed statistical differences in the UMAT test between patients with and without FI.

Clinical trials registry NCT03851354. February 22, 2019.