期刊
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION
卷 47, 期 5, 页码 614-623出版社
WILEY
DOI: 10.1002/jpen.2502
关键词
administration; critical care; enteral access; enteral nutrition; nutrition; nutrition support practice; research and diseases
This study analyzed the current practice of gastric residual volume (GRV) measurement in critically ill patients and its association with clinical outcomes. The study found significant variability in GRV measurement techniques but this did not affect the amount of GRV. High GRV may serve as a marker of gastrointestinal dysfunction and disease severity, but it is not associated with mortality or number of ventilator-free days.
BackgroundGastric residual volume (GRV) measurement to detect gastrointestinal (GI) dysfunction is a common diagnostic procedures in critical care, albeit still not well standardized being operator-, patient-, and tube-dependent. Our aim was to describe current practice of GRV measurements and its association with clinical outcomes in critically ill patients. MethodsThis was a secondary analysis of an international prospective observational cohort study (intestinal-specific organ function assessment). Eligibility criteria were defined as >= 1 GRV measurement during the 7-day study period. Data collection included GRV measurement practices, tube diameters and volumes, symptoms of GI dysfunction, and clinical outcomes. The primary aim was to describe current practices of GRV measurements, and the secondary aim was to test the association of high (>200 ml) vs. low GRV with symptoms of GI dysfunction and clinical outcomes using generalized linear regression and survival models. ResultsTwo hundred fifty-eight patients with 2422 GRV measurements on 875 study days were analyzed. GRV was mainly measured via passive drainage twice daily using large diameter tubes. There was no significant association between tube size or measurement technique and high GRV. High GRV occurred in 34% of patients and was associated with other GI symptoms and with increased disease severity but not with 28-day or 90-day mortality, intensive care unit-free and ventilator-free days. ConclusionThere was substantial variability of GRV measurement techniques, but this had no impact on the amount of GRV. High GRV was not associated with mortality or ventilator-free days but may serve as a marker of GI dysfunction and disease severity.
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