Elizabeth Deja1, Louise Roper2, Lyvonne N Tume3, Jon Dorling4, Chris Gale5, Barbara Arch6, Lynne Latten7, Nazima Pathan8, Helen Eccleson6, Helen Hickey6, Jenny Preston9, Anne Beissel10, Izabela Andrzejewska11, Frédéric V Valla12,13, Kerry Woolfall2. 1. Institute of Population Health, University of Liverpool, Liverpool, UK. E.deja@liverpool.ac.uk. 2. Institute of Population Health, University of Liverpool, Liverpool, UK. 3. School of Health & Society, University of Salford, Manchester, M6 6PU, UK. 4. Division of Pediatrics and Neonatal-Perinatal Medicine, Dalhousie University, Halifax, Canada. 5. Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital campus, London, UK. 6. Medicines for Children Clinical Trials Unit, Clinical Trials Research Centre, University of Liverpool Institute of Child Health Alder Hey Children's NHS Foundation Trust Liverpool, Liverpool, UK. 7. Department of Dietetics, Alder Hey Children's Hospital, Liverpool, UK. 8. Paediatric Intensive Care, University of Cambridge, Addenbrooke's Hospital Cambridge, Campbridge, UK. 9. Institute of Translational Medicine, University of Liverpool, Liverpool, UK. 10. Neonatal Intensive Care Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon-Bron, France. 11. Neonatal Intensive Care Unit, Chelsea and Westminster Hospital, London, UK. 12. Faculty of Health & Applied Sciences, University of the West of England, Bristol, UK. 13. Pediatric Intensive Care Unit, CarMEN INSERM UMR 1060 Equipe INFOLIP, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon-Bron, France.
Abstract
BACKGROUND: Routine measurement of gastric residual volume (GRV) to guide feeding in neonatal and paediatric intensive care is widespread. However, this practice is not evidence based and may cause harm. As part of a feasibility study, we explored parent and practitioner views on the acceptability of a trial comparing GRV measurement or no GRV measurement. METHODS: A mixed-methods study involving interviews and focus groups with practitioners and interviews with parents with experience of tube feeding in neonatal and/or paediatric intensive care. A voting system recorded closed question responses during practitioner data collection, enabling the collection of quantitative and qualitative data. Data were analysed using thematic analysis and descriptive statistics. RESULTS: We interviewed 31 parents and nine practitioners and ran five practitioner focus groups (n=42). Participants described how the research question was logical, and the intervention would not be invasive and potential benefits of not withholding the child's feeds. However, both groups held concerns about the potential risk of not measuring GRV, including delayed diagnosis of infection and gut problems, increased risk of vomiting into lungs and causing discomfort or pain. Parent's views on GRV measurement and consent decision making were influenced by their views on the importance of feeding in the ICU, their child's prognosis and associated comorbidities or complications. CONCLUSIONS: The majority of parents and practitioners viewed the proposed trial as acceptable. Potential concerns and preferences were identified that will need careful consideration to inform the development of the proposed trial protocol and staff training.
BACKGROUND: Routine measurement of gastric residual volume (GRV) to guide feeding in neonatal and paediatric intensive care is widespread. However, this practice is not evidence based and may cause harm. As part of a feasibility study, we explored parent and practitioner views on the acceptability of a trial comparing GRV measurement or no GRV measurement. METHODS: A mixed-methods study involving interviews and focus groups with practitioners and interviews with parents with experience of tube feeding in neonatal and/or paediatric intensive care. A voting system recorded closed question responses during practitioner data collection, enabling the collection of quantitative and qualitative data. Data were analysed using thematic analysis and descriptive statistics. RESULTS: We interviewed 31 parents and nine practitioners and ran five practitioner focus groups (n=42). Participants described how the research question was logical, and the intervention would not be invasive and potential benefits of not withholding the child's feeds. However, both groups held concerns about the potential risk of not measuring GRV, including delayed diagnosis of infection and gut problems, increased risk of vomiting into lungs and causing discomfort or pain. Parent's views on GRV measurement and consent decision making were influenced by their views on the importance of feeding in the ICU, their child's prognosis and associated comorbidities or complications. CONCLUSIONS: The majority of parents and practitioners viewed the proposed trial as acceptable. Potential concerns and preferences were identified that will need careful consideration to inform the development of the proposed trial protocol and staff training.
Entities:
Keywords:
Acceptability; Feasibility; Gastric residual volume; Intensive care
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