scholarly journals Gastric residual volume measurement in British neonatal intensive care units: a survey of practice

2020 ◽  
Vol 4 (1) ◽  
pp. e000601
Author(s):  
Jon Dorling ◽  
Lyvonne Tume ◽  
Barbara Arch ◽  
Kerry Woolfall ◽  
Lynne Latten ◽  
...  
Keyword(s):  
Enteral Feeding ◽  
Neonatal Intensive Care ◽  
Online Survey ◽  
Volume Measurement ◽  
Neonatal Intensive Care Units ◽  
Residual Volume ◽  
Gastric Residual Volume ◽  
Feeding Method ◽  
Regular Time ◽  
Measurement Practices

ObjectiveDespite little evidence, the practice of routine gastric residual volume (GRV) measurement to guide enteral feeding in neonatal units is widespread. Due to increased interest in this practice, and to examine trial feasibility, we aimed to determine enteral feeding and GRV measurement practices in British neonatal units.Design and settingAn online survey was distributed via email to all neonatal units and networks in England, Scotland and Wales. A clinical nurse, senior doctor and dietitian were invited to collaboratively complete the survey and submit a copy of relevant guidelines.Results95/184 (51.6%) approached units completed the survey, 81/95 (85.3%) reported having feeding guidelines and 28 guidelines were submitted for review. The majority of units used intermittent (90/95) gastric feeds as their primary feeding method. 42/95 units reported specific guidance for measuring and interpreting GRV. 20/90 units measured GRV before every feed, 39/90 at regular time intervals (most commonly four to six hourly 35/39) and 26/90 when felt to be clinically indicated. Most units reported uncertainty on the utility of aspirate volume for guiding feeding decisions; 13/90 reported that aspirate volume affected decisions ‘very much’. In contrast, aspirate colour was reported to affect decisions ‘very much’ by 37/90 of responding units. Almost half, 44/90, routinely returned aspirates to the stomach.ConclusionsRoutine GRV measurement is part of standard practice in British neonatal units, although there was inconsistency in how frequently to measure or how to interpret the aspirate. Volume was considered less important than colour of the aspirate.

scholarly journals Gastric Residual Volume Measurement in U.K. PICUs

2019 ◽  
Vol 20 (8) ◽  
pp. 707-713 ◽  
Author(s):  
Lyvonne N. Tume ◽  
Barbara Arch ◽  
Kerry Woolfall ◽  
Lynne Latten ◽  
Elizabeth Deja ◽  
...  
Keyword(s):  
Volume Measurement ◽  
Residual Volume ◽  
Gastric Residual Volume

scholarly journals Enteral Feeding and Gastric Residual Volume: A Regional Survey

2011 ◽  
Vol 140 (5) ◽  
pp. S-863
Author(s):  
Vu Le ◽  
Shoaib Ahmad ◽  
Siddharth A. Wayangankar ◽  
Sindhu R. Kaitha ◽  
Jordan Morton ◽  
...  
Keyword(s):  
Enteral Feeding ◽  
Residual Volume ◽  
Gastric Residual Volume ◽  
Regional Survey

scholarly journals Is It Time to Review Guidelines for ETT Positioning in the NICU? SCEPTIC—Survey of Challenges Encountered in Placement of Endotracheal Tubes in Canadian NICUs

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Pankaj Sakhuja ◽  
Michael Finelli ◽  
Judy Hawes ◽  
Hilary Whyte
Keyword(s):  
Nurse Practitioners ◽  
Neonatal Intensive Care ◽  
Online Survey ◽  
Tube Placement ◽  
Neonatal Intensive Care Units ◽  
Respiratory Therapists ◽  
Endotracheal Tube Placement ◽  
Wide Variability ◽  
Chest X Ray ◽  
Tip Position

Objectives. To examine current opinions and practices regarding endotracheal tube placement across several Canadian Neonatal Intensive Care Units.Design. Clinical directors from Canadian Neonatal Network affiliated NICUs and Neonatal-Perinatal Programs across Canada were invited via email to participate in and disseminate the online survey to staff neonatologists, neonatal fellows, respiratory therapists, and nurse practitioners.Result. There is wide variability in the beliefs and practices related to ETT placement. The majority use “weight +6” formula and “aim to black line” on ETT at vocal cords to estimate the depth of an oral ETT and reported estimation as challenging in ELBW infants. The majority agreed that mid-trachea is an ideal ETT tip position; however their preferred position on chest X-ray varied. Many believe that ETT positioning could be improved with more precise ETT markings.Conclusion. Further research should focus on developing more effective guidelines for ETT tip placement in the ELBW infants.

1194: GASTRIC RESIDUAL VOLUME: FAILURE OF ADHERENCE TO ENTERAL FEEDING GUIDELINES

2016 ◽  
Vol 44 (12) ◽  
pp. 374-374
Author(s):  
Emmanuel Kyereme-Tuah ◽  
Arvind Kalyan Sundaram ◽  
Kenneth Widom ◽  
Uchenna Ofoma
Keyword(s):  
Enteral Feeding ◽  
Residual Volume ◽  
Gastric Residual Volume

scholarly journals P0080 / #320: IS A TRIAL OF NO ROUTINE GASTRIC RESIDUAL VOLUME MONITORING TO GUIDE ENTERAL FEEDING IS POSSIBLE IN UK PICUS AND NICUS?

2021 ◽  
Vol 22 (Supplement 1 3S) ◽  
pp. 73-73
Author(s):  
L. Tume ◽  
F. Valla ◽  
C. Gale ◽  
B. Arch ◽  
N. Pathan ◽  
...  
Keyword(s):  
Enteral Feeding ◽  
Residual Volume ◽  
Gastric Residual Volume

Intermittent feeding in intensive care – the theory and practice

2021 ◽  
Vol 100 (2) ◽  
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Enteral Feeding ◽  
Critically Ill Patients ◽  
Muscle Protein ◽  
Muscle Protein Synthesis ◽  
Abdominal Discomfort ◽  
Residual Volume ◽  
Gastric Residual Volume ◽  
Intermittent Feeding

Introduction: Nutrition therapy becomes one of the fundamental conditions of a successful outcome in malnourished patients and in critically ill patients. The administration of enteral feeding in critically ill patients is mostly performed by continuous or cyclic feeding. On the contrary, the potential benefits of intermittent feeding include increased muscle protein synthesis. This review outlines the theory of a possible anabolic effect of intermittent feeding. The authors describe their experience with implementation of this method of administration in the intensive care unit including the follow-up of possible complications and adverse effects. Methods: Six patients with intermittent feeding were followed retrospectively during the study period. In addition to demographic data, potential complications related to intermittent enteral feeding (aspiration pneumonia, increased gastric residual volume, abdominal discomfort, osmotic diarrhoea) were evaluated. Results: The average time of intermittent feeding was 8 days. The sum of intermittent feeding days was 63. No aspiration followed by pneumonia was detected during this period. The gastric residual volume did not increase, either. Abdominal discomfort and osmotic diarrhoea were not observed in any patient. Conclusion: Although continuous and cyclic enteral feeding in critically ill patients remains the standard and the most common practice, it is considered as a non-physiological method with possible negative consequences for the patient. On the other hand, intermittent feeding is theoretically associated with respecting of the circadian rhythm and with activation of autophagy. Intermittent feeding increases muscle protein synthesis and supports the release of fatty acids. As shown by our observational study, intermittent administration of enteral nutrition in intensive care can be implemented without any adverse effects; however, it is more time consuming for the nurses.

scholarly journals A national survey of the enteral feeding practices in Canadian neonatal intensive care units

2019 ◽  
Vol 25 (8) ◽  
pp. 529-533
Author(s):  
James Haiyang Xu ◽  
Helen Coo ◽  
Sandra Fucile ◽  
Eugene Ng ◽  
Joseph Y Ting ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Enteral Feeding ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Feeding Practices ◽  
Neonatal Intensive Care Units ◽  
Total Fluid Intake ◽  
Low Birth Weight Infants ◽  
Neurodevelopmental Outcomes

Abstract Aim Nutrition affects the growth and neurodevelopmental outcomes of preterm infants, yet controversies exist about the optimal enteral feeding regime. The objective of this study was to compare enteral feeding guidelines in Canadian neonatal intensive care units (NICUs). Method The research team identified key enteral feeding practices of interest. Canadian Neonatal Network site investigators at 30 Level 3 NICUs were contacted to obtain a copy of their 2016 to 2017 feeding guidelines for infants who weighed less than 1,500 g at birth. Each guideline was reviewed to compare recommendations around the selected feeding practices. Results Five of the 30 NICUs did not have a feeding guideline. The other 25 NICUs used 22 different enteral feeding guidelines. The guidelines in 40% of those NICUs recommend commencing minimal enteral nutrition (MEN) within 24 hours of birth and maintaining that same feeding volume for 24 to 96 hours. In 40% of NICUs, the guideline recommended that MEN be initiated at a volume of 5 to 10 mL/kg/day for infants born at <1,000 g. Guidelines in all 25 NICUs recommend the use of bovine-based human milk fortifier (HMF), and in 56% of NICUs, it is recommended that HMF be initiated at a total fluid intake of 100 mL/kg/day. Guidelines in only 16% of NICUs recommended routine gastric residual checks. Donor milk and probiotics are used in 76% and 72% of the 25 NICUs, respectively. Conclusion This study revealed substantial variability in recommended feeding practices for very low birth weight infants, underscoring the need to establish a national feeding guideline for this vulnerable group.

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