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

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Title: Gastric residual volume measurement in British neonatal intensive care units: a survey of practice
Authors: Dorling, J
Tume, LN
Arch, B
Woolfall, K
Latten, L
Roper, L
Deja, E
Pathan, N
Eccleson, H
Hickey, H
Brown, M
Beissel, A
Andrzejewska, A
Valla, FV
Gale, C
Item Type: Journal Article
Abstract: 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 & 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 4-6 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.
Issue Date: 7-Aug-2020
Date of Acceptance: 11-Jun-2020
URI: http://hdl.handle.net/10044/1/80944
DOI: 10.1136/bmjpo-2019-000601
ISSN: 2399-9772
Publisher: BMJ Publishing Group
Journal / Book Title: BMJ Paediatrics Open
Volume: 4
Copyright Statement: © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
Sponsor/Funder: Health Technology Assessment programme
Funder's Grant Number: 16/94/02
Keywords: gastroenterology
measurement
neonatology
Publication Status: Published
Article Number: ARTN e000601
Online Publication Date: 2020-08-07
Appears in Collections:Faculty of Medicine
School of Public Health



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