151. Is monitoring of gastric residual volume for critically ill patients with enteral nutrition necessary? A meta‐analysis and systematic review.
- Author
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Feng, Limei, Chen, Judi, and Xu, Qin
- Subjects
MEDICAL databases ,ONLINE information services ,META-analysis ,CONFIDENCE intervals ,CRITICALLY ill ,SYSTEMATIC reviews ,PATIENTS ,GASTROINTESTINAL contents ,ACQUISITION of data ,ARTIFICIAL respiration ,DESCRIPTIVE statistics ,CHI-squared test ,MEDICAL records ,QUALITY assurance ,RESEARCH funding ,ENTERAL feeding ,MEDLINE ,ODDS ratio - Abstract
Background: There are many controversies over the necessity of monitoring gastric residual volume in the nursing care of enteral nutrition. We aimed to conduct an updated meta‐analysis to evaluate the effects of monitoring or not monitoring gastric residual volume on patients' outcomes and complications. Methods: We searched the Cochrane Library database to 15 April 2021 for randomized controlled trials (RCTs) on the effects of gastric residual volume and no gastric residual volume monitoring. Review Manager software was used for data analysis. Results: A total of seven RCTs involving 1240 enteral nutrition patients were included. Gastric residual volume monitoring was associated with reduced incidence of vomiting (OR2.33, 95% CI:1.68–3.24), whereas no gastric residual volume monitoring was associated with reduced incidence of unnecessary interruptions of enteral nutrition (OR0.38,95% CI:0.26–0.55). There were no significant differences on the incidence of abdominal distention (OR1.87, 95% CI:0.82–4.28), diarrhoea (OR1.03,95% CI:0.74–1.43), VAP (OR0.83, 95%CI:0.37–1.89), duration of mechanical ventilation (MD −0.06,95% CI:−1.22–1.10), length of ICU stay (MD −1.33, 95% CI:−3.58–0.91) and mortality (OR0.90,95% CI:0.61–1.34). Conclusions: Not monitoring gastric residual volume is associated with reduced unnecessary interruptions of enteral nutrition related to inadequate feeding and increased risk of vomiting. Summary statement: What is already known about this topic? Enteral nutrition is vital to the prognosis of critically ill patients.Monitoring the gastric residual volume has been used for the safety of enteral nutrition.The role of gastric residual volume monitoring in critically ill patients remains unclear. What this paper adds? Monitoring gastric residual volume is associated with reduced incidence of vomiting.Not monitoring gastric residual volumes may reduce unnecessary interruptions of enteral nutrition.There are no significant differences on the incidence of abdominal distention, diarrhoea, VAP, duration of mechanical ventilation, length of ICU stay and mortality between patients with or without gastric residual volume monitoring. The implications of this paper: Omission of gastric residual volume monitoring may result in more complete delivery of prescribed enteral nutrition and hence of better nutritional support / status for these patients.The role of gastric residual volume monitoring on enteral safety and nutritional intake of ICU patient needs further investigation. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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