TY - JOUR
T1 - Gastric residual volume measurement in British neonatal intensive care units
T2 - A survey of practice
AU - Dorling, Jon
AU - Tume, Lyvonne
AU - Arch, Barbara
AU - Woolfall, Kerry
AU - Latten, Lynne
AU - Roper, Louise
AU - Deja, Elizabeth
AU - Pathan, Nazima
AU - Eccleson, Helen
AU - Hickey, Helen
AU - Brown, Michaela
AU - Beissel, Anne
AU - Andrzejewska, Izabela
AU - Valla, Frederic
AU - Gale, Chris
N1 - Funding Information:
Competing interests JD reports grants from National Institute for Health Research (NIHR), during the conduct of the study; grants from NIHR, grants from Nutrinia, outside the submitted work. LT reports grant from NIHR, during the conduct of the study. ED reports grants from NIHR Health Technology Assessment (HTA) programme during the conduct of the study. HE reports grants from NIHR HTA during the conduct of the study. HH reports this grant from NIHR HTA, during the conduct of the study. MB reports grants from NIHR HTA during the conduct of the study. CG reports grants from NIHR, during the conduct of the study; grants from NIHR, grants from Medical Research Foundation, grants from Mason Medical Research Foundation, grants and personal fees from Chiesi Pharmaceuticals, grants from Rosetrees Foundation, grants from Canadian Institute for Health Research, outside the submitted work. FV reports personal fees from Baxter, personal fees from Nutricia, outside the submitted work. LT reports grants from NIHR during the conduct of the study.
Funding Information:
Funding This work was supported by NIHR HTA programme as part of a larger NIHR HTA-funded feasibility study (grant number 16/94/02).
Publisher Copyright:
©
PY - 2020/8/7
Y1 - 2020/8/7
N2 - Objective Despite 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 setting An 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. Results 95/184 (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. Conclusions Routine 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.
AB - Objective Despite 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 setting An 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. Results 95/184 (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. Conclusions Routine 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.
KW - gastroenterology
KW - measurement
KW - neonatology
UR - http://www.scopus.com/inward/record.url?scp=85090150463&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85090150463&partnerID=8YFLogxK
UR - https://research.edgehill.ac.uk/en/publications/51bd9b86-70df-4acb-8a1e-67ed2700044f
U2 - 10.1136/bmjpo-2019-000601
DO - 10.1136/bmjpo-2019-000601
M3 - Article (journal)
AN - SCOPUS:85090150463
SN - 2399-9772
VL - 4
JO - BMJ Paediatrics Open
JF - BMJ Paediatrics Open
IS - 1
M1 - e000601
ER -