Application of bedside ultrasound measurement of gastric antrum cross-sectional area combined with AGIUS score in early individualized enteral nutrition therapy for sepsis patients
10.3969/j.issn.1671-8348.2025.04.009
- VernacularTitle:床旁超声测量胃窦横截面积联合AGIUS评分对脓毒症患者早期个体化肠内营养治疗的应用效果研究
- Author:
Ren HUANG
1
;
Yan SHAGN
;
Shuqi LI
;
Mingying TANG
;
Yanhong XU
;
Wenjuan HUANG
;
Rongwen WAN
Author Information
1. 湖南省中西医结合医院/湖南省中医药研究院附属医院重症医学科,长沙 410006
- Keywords:
sepsis;
gastrointestinal dysfunction;
enteral nutrition therapy;
personalized;
gastric antrum ultrasound;
AGIUS score
- From:
Chongqing Medicine
2025;54(4):845-851
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the application value of bedside ultrasound measurement of gastric antrum cross-sectional area(CSA)combined with acute gastrointestinal injury ultrasound(AGIUS)score in guiding early individualized enteral nutrition therapy for sepsis patients.Methods From January 2023 to July 2024,61 sepsis patients meeting diagnostic criteria were enrolled and divided into an observation group(n=30)and a control group(n=31).The observation group underwent bedside ultrasound monitoring of gastric antrum CSA to calculate gastric residual volume(GRV)and AGIUS score for formulating individualized en-teral nutrition strategies.The control group used gastric tube withdrawal method for GRV measurement to guide enteral nutrition.Clinical baseline characteristics,enteral nutrition-related complications,nutritional/in-fection indicators,and disease severity parameters were compared between groups.Predictive efficacy was ana-lyzed using receiver operating characteristic(ROC)curve and area under the curve(AUC).Results Both groups showed gradual increases in enteral nutrition feeding rates and total volumes over time,with the obser-vation group demonstrating significantly higher values than the control group at each time point(P＜0.05).The observation group started nasogastric feeding earlier than the control group(P＜0.05).Target calorie a-chievement rates on day 3,5,and 7 were better in the observation group(P＜0.05).The incidence of feeding intolerance progressively decreased in the observation group but increased in the control group over day 1,3,and 5,with significant intergroup differences at each time point(P＜0.05).By day 7,the observation group exhibited significantly higher prealbumin(PA),albumin(ALB),and transferrin(TF)levels compared to day 1 and the control group(P＜0.05).Both groups showed reductions in APACHE Ⅱ,SOFA,and AGI scores by day 7,with the observation group displaying significantly lower scores than the control group(P＜0.05).The observation group had shorter ICU stays[(10.83±3.26)d vs.(14.55±3.14)d,P＜0.05].The combination of gastric antrum CSA measurement and AGIUS scoring demonstrated excellent predictive value for feeding intolerance(AUC=0.920,95％CI:0.848-0.963),with 95.50％sensitivity and 82.50％specificity,achieving 87.60％predictive accuracy.Conclusion Bedside ultrasound measurement of gastric antrum cross-sectional area(CSA)combined with AGIUS scoring shows good effect as a safe and effective monitoring modality for guiding early individualized enteral nutrition therapy in sepsis patients.
