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

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• 作者：Nurten Ozen ; RN ; PhD^a ; ^{ozenurten@yahoo.com.tr" class="auth_mail" title="E-mail the corresponding author} ; Nuran Tosun ; RN ; PhD^b ; ¹ ; ^{ntosun@gata.edu.tr" class="auth_mail" title="E-mail the corresponding author} ; Levent Yamanel ; MD^c ; ² ; ^{lyamanel@gata.edu.tr" class="auth_mail" title="E-mail the corresponding author} ; Neriman Defne Altintas ; MD^d ; ³ ; ^{defne98hac@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Guldem Kilciler ; MD^e ; ⁴ ; ^{guldemd@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Volkan Ozen ; MD^f ; ⁵ ; ^{vozen81@gmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Evidence-based practice ; Gastric residual volume ; Gastroesophageal reflux ; Intolerance ; Nutritional adequacy ; pH monitoring
• 刊名：Journal of Critical Care
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：33
• 期：Complete
• 页码：137-144
• 全文大小：488 K

文摘

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.