Gastric Residual Volume Measurement in UK PICUs: A Survey of Practice*

被引：16

作者：

Tume, Lyvonne N. ^{[1
]}

Arch, Barbara ^{[2
]}

Woolfall, Kerry ^{[3
]}

Latten, Lynne ^{[4
]}

Deja, Elizabeth ^{[5
]}

Roper, Louise ^{[5
]}

Pathan, Nazima ^{[6
]}

Eccleson, Helen ^{[7
]}

Hickey, Helen ^{[7
]}

Brown, Michaela ^{[7
]}

Beissel, Anne ^{[8
]}

Andrzejewska, Izabela ^{[9
]}

Gale, Chris ^{[10
]}

Valla, Frederic V. ^{[11
,12
]}

Dorling, Jon ^{[13
,14
]}

机构：

[1] Univ West England, Fac Hlth & Appl Sci, Child Hlth, Bristol, Avon, England

[2] Univ Liverpool, Alder Hey Childrens NHS Fdn Trust Liverpool, Inst Child Hlth, Med Children Clin Trials Unit,Clin Trials Res Ctr, Liverpool, Merseyside, England

[3] Univ Liverpool, Dept Hlth Serv Res, MRC Hubs Trials Methodol Res, Liverpool, Merseyside, England

[4] Alder Hey Childrens Hosp, Dept Dietet, Liverpool, Merseyside, England

[5] Univ Liverpool, Dept Hlth Serv Res, Liverpool, Merseyside, England

[6] Univ Cambridge, Addenbrookes Hosp Cambridge, Paediat Intens Care, Cambridge, England

[7] Univ Liverpool, Alder Hey Childrens NHS Fdn Trust Liverpool, Inst Child Hlth, Med Children Clin Trials Unit,Clin Trials Res Ctr, Liverpool, Merseyside, England

[8] Hosp Civils Lyon, Hop Femme Mere Enfant, Neonatal Intens Care Unit, Lyon, France

[9] Chelsea & Westminster Hosp, Neonatal Unit Neonatal, London, England

[10] Imperial Coll London, Neonatal Med, Chelsea & Westminster Hosp Campus, London, England

[11] Hosp Civils Lyon, Hop Femme Mere Enfant, Pediat Intens Care Unit, CarMEN,INSERM,UMR 1060,Equipe INFOLIP, Lyon, France

[12] Univ West England, Fac Hlth & Appl Sci, Bristol, Avon, England

[13] Dalhousie Univ, Div Pediat & Neonatal Perinatal Med, Halifax, NS, Canada

[14] IWK Hlth Ctr, Halifax, NS, Canada

来源：

PEDIATRIC CRITICAL CARE MEDICINE | 2019年 / 20卷 / 08期

基金：

美国国家卫生研究院;

关键词：

children; enteral feeding; intensive care; neonates; nutrition; ROUTINE EVALUATION; ENTERAL NUTRITION; IMPACT;

D O I：

10.1097/PCC.0000000000001944

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Objectives: Despite little evidence, the practice of routine measurement of gastric residual volume to guide both the initiation and delivery of enteral feeding in PICUs is widespread internationally. In light of increased scrutiny of the evidence surrounding this practice, and as part of a trial feasibility study, we aimed to determine enteral feeding and gastric residual volume measurement practices in U.K. PICUs. Design: An online survey to 27 U.K. PICUs. Setting: U.K. PICUs. Subjects: A clinical nurse, senior doctor, and dietician were invited to collaboratively complete one survey per PICU and send a copy of their unit guidelines on enteral feeding and gastric residual volume. Interventions: None. Measurement and Main Results: Twenty-four of 27 units (89%) approached completed the survey. Twenty-three units (95.8%; 23/24) had written feeding guidelines, and 19 units (19/23; 83%) sent their guidelines for review. More units fed continuously (15/24; 62%) than intermittently (9/24; 37%) via the gastric route as their primary feeding method. All but one PICU routinely measured gastric residual volume, regardless of the method of feeding. Eighteen units had an agreed definition of feed tolerance, and all these included gastric residual volume. Gastric residual volume thresholds for feed tolerance were either volume based (mL/kg body weight) (11/21; 52%) or a percentage of the volume of feed administered (6/21; 29%). Yet only a third of units provided guidance about the technique of gastric residual volume measurement. Conclusions: Routine gastric residual volume measurement is part of standard practice in U.K. PICUs, with little guidance provided about the technique which may impact the accuracy of gastric residual volume. All PICUs that defined feed tolerance included gastric residual volume in the definition. This is important to know when proposing a standard practice arm of any future trial of no-routine gastric residual volume measurement in critically ill children.

引用

页码：707 / 713

页数：7

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