Enteral nutrition and gastric residual volume


The usefulness of bedside assessment of residual gastric volume in predicting aspiration has been questioned, as has volume that signals an increased risk of aspiration.

Objective is To describe the association between residual gastric volumes and aspiration of gastric contents.

Methods: In a prospective study of 206 critically ill patients receiving gastric feeding for 3 consecutive days, residual gastric volumes were measured with 60 ml syringes every 4 hours.

The residual gastric volumes were compared between the 2 aspiration activities.
Results: Approximately 39% of 206 patients had 1 or more residual gastric volumes of at least 150 mL, 27% had 1 or more residual volumes of at least 200 mL, and 17% had 1 or more residual gastric volumes of at least 250 mL. caliber identified most of the high volumes.

Frequent vacuuming had a significantly higher frequency of 2 or more volumes of at least 200 mL and 1 or more volumes of at least 250 mL.

Many clinicians accept as true with or anticipate that there’s tight correlation among aspiration of gastric contents and an increased GRV.

Endogenous Secretions
To completely respect all of the elements that make contributions to a GRV, one ought to bear in mind each endogenous secretions in addition to exogenous contributions (meals, water flushes, enteral feeding, medications, etc.) that could percentage the gastric reservoir .In scientific exercise, a number of of things may also have an effect on the general quantity of those secretions.

Gastric Emptying
Gastric emptying is a complicated physiologic process, and unusual gastric emptying research do now no longer usually correlate to scientific symptoms .Gastric emptying is distinct for beverages in comparison to solids.The last amount of liquid is emptied at a slower price. Solids emptying follows 0-order kinetics.

Positional effects (cascade effect)
There is a concern that after measuring IBCs, the total amount of gastric contents is not completely aspirated. At least separate issues in scientific practice negate or compromise such assumptions. Conversely, if the end of the tube tended to live inside the fundus, placing the affected person on their back, the fundus is inside the basal function and the contents should accumulate in this part of the belly. .Either way, these issues can lead to inaccuracy, too low an IBC, and a false sense of security. This maneuver presents an exciting skill method for responding or dealing with an augmented LARP.

The use of GRV has in no way been shown to improve an individual’s end results or reduce headaches. At present, the facts derived from this exercise are inaccurate, do little to protect the data subject and may in any case have a negative effect on the final results of the data subject.

Any problem related to the care of the affected person is linked to an expenditure of health care dollars. The nursing time required to test IBCs every 4 hours is a generalized burden on the nursing corps of workers and the allocation of healthcare resources. The suggested time period for testing an IBC becomes 5.25 minutes.This value no longer includes the system used which includes syringes, isolation gowns, etc., or misplaced sleep from pages to doctors in the middle of the night, lack of vitamins for the sick due to a withheld EN , etc

Control of residual gastric volumes
Physical exams and X-ray readings were no longer tied to IBCs. In a potential review of 153 critically ill patients, Mentec documented the frequency, randomness, and headache associated with increased digestive intolerance (described as: GRV between one hundred and fifty 500 mL in consecutive measurements; in which GRV > 500 mL; or vomit) at some point.

Conclusions: No consistent relationship was found between aspiration and gastric residual volumes. Although aspiration occurs without high residual gastric volumes, it occurs particularly more often when volumes are high.

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