Evaluation of the effect on patient parameters of not monitoring gastric residual volume in intensive care patients on a mechanical ventilator receiving enteral feeding: A randomized clinical trial

J Crit Care. 2016 Jun:33:137-44. doi: 10.1016/j.jcrc.2016.01.028. Epub 2016 Feb 10.

Abstract

Purpose: This study aimed to evaluate the effects of not measuring gastric residual volume (GRV) in intensive care patients on a mechanical ventilator and receiving enteral feeding on the feeding intolerance, gastroesophageal reflux (GER) risk, and nutritional adequacy.

Methods: This randomized clinical study was performed in 2 medical intensive care units of 2 university hospitals in Ankara, Turkey. The patients were randomized into 2 groups. In the group with GRV monitoring, GRV was measured 3 times a day, and the GRV threshold was accepted as 250 mL. In addition, 24-hour pH monitoring was used in this group to assess the risk of GER. In the group without GRV monitoring, GRV was not measured. The patients were followed-up for 5 days.

Results: The feeding targets were reached more quickly in the group without GRV monitoring (n = 26) with no increase in the complication rate (P < .05). No significant relationship was found between GRV and GER in the group with GRV monitoring (n = 25) (P > .05).

Conclusion: The discrepancies in GRV measurement make it unreliable for monitoring feeding intolerance and GER. The use of GRV measurements may therefore be discontinued as part of the standard care protocol in medical intensive care units.

Keywords: Evidence-based practice; Gastric residual volume; Gastroesophageal reflux; Intolerance; Nutritional adequacy; pH monitoring.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Critical Care
  • Critical Illness / therapy*
  • Enteral Nutrition* / methods
  • Female
  • Gastroesophageal Reflux / prevention & control*
  • Gastrointestinal Contents*
  • Hospitals, University
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Pneumonia, Ventilator-Associated / prevention & control*
  • Respiration, Artificial*
  • Turkey