Nurten Ozen1, Nuran Tosun2, Levent Yamanel3, Neriman Defne Altintas4, Guldem Kilciler5, Volkan Ozen6. 1. Kasimpasa Military Hospital, Istanbul, Turkey. Electronic address: ozenurten@yahoo.com.tr. 2. Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey. Electronic address: ntosun@gata.edu.tr. 3. Gulhane Military Academy of Medicine, Department of Critical Care, Ankara, Turkey. Electronic address: lyamanel@gata.edu.tr. 4. Ankara Ataturk Training and Research Hospital, Intensive Care Unit, Ankara, Turkey. Electronic address: defne98hac@yahoo.com. 5. Gulhane Military Academy of Medicine, Department of Gastroenterology, Ankara, Turkey. Electronic address: guldemd@yahoo.com. 6. Kasımpasa Military Hospital, Department of Anestesiology and Reanimation, Istanbul, Turkey. Electronic address: vozen81@gmail.com.
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.
RCT Entities:
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.
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