الفهرس 
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Abstract
Summary
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Summary
Enteral feeding intolerance is defined as the failure to provide
sufficient EN to critically ill patients due to delay of gastric emptying
with the absence of mechanical blocking (Elmokadem et al., 2021). It
may affect the effectiveness of enteral feeding, thereby prolonging
hospital stay and increasing mortality rate. So, the aim of this study is to
investigate tube feeding intolerance among critically ill patients at Assiut
University Hospital. The design of this study was a descriptive
exploratory survey research design. This study was conducted at general,
trauma, coronary, anesthesia, and Alraghi intensive care units at Assiut
University Hospital, Egypt.
A purposive sample of 65 adult male and female critically ill
patients receiving enteral feeding within 24-48 hours of their admission to
the intensive care unit and participated in study with the following
inclusion criteria as patient with age ranged between 18-60 years and
exclusion criteria as patients with hemodynamic instability, uncontrolled
shock, uncontrolled life-threatening hypoxemia, hypercapnia, or acidosis,
active GI bleeding, bowel discontinuity, overt bowel ischemia, abdominal
compartment syndrome, high output intestinal fistula, continued
obstruction of the GI tract, gastric residual volume >500 mL/6hrs, brain
death, stomach cancer, abdominal trauma, osophageal varices and
delayed initiation of EN (>48 hours) in the absence of contraindication to
EN and they were excluded from the study. Four tools were utilized to
collect data, which are: Tool I: Adult critically ill tube feeding
intolerance manifestations assessment sheet. Tool II: Nutrition status
assessment tool by using The Mini Nutritional Assessment Short-Form.
Tool III: Enteral feeding intolerance risk factors assessment sheet. Tool
IV: Adult critically ill tube feeding intolerance complications assessment
Summary
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sheet. A pilot study carried out in order to assess the feasibility and
applicability of the tools and the necessary modifications were done. The
pilot study was done on 7 patients were included in the study.
The main results:-
The mean age of studied sample was (36.57±10.34); about (33.8%) of
patients their age ranged from 40 - < 50 yrs. and (55.4%) were males.
The majority of patients (84.6%) manifested by equal to or more than
two symptoms of enteral feeding intolerance.
Results revealed that pain, stress, bed rest, use of broad-spectrum
antibiotics were common risks for enteral feeding intolerance for all
patients (100%). The majority of patients (90.8%) took sedative or
analgesic agents and had hypoproteinemia, (83.1%) were connected
with mechanical ventilator, but age >60 yrs., abdominal surgery and
acute/severe pancreatitis weren’t matched in studied sample (0%).
Results clarified that more than two thirds of patients suffered from
vomiting, constipation, flatulence, abdominal distention and straining
{(69.2) (69.2) (66.2) (64.6) (64.6)} respectively while more than one
third of patients (32.3%) suffered from diarrhea.
There was positive correlation between patient’s age and frequency of
tube feeding intolerance with statistical significance; p values (0.045*).
Results showed that the majority of patients (83.1%) were connected
with mechanical ventilator, more than two thirds of patients