Gastric residual volume and aspiration in critically ill patients receiving gastric feedings.
BACKGROUND
The helpfulness of bedside assessment of gastric residual volume in the prediction of aspiration has been questioned, as has the volume that signals increased risk of aspiration.


OBJECTIVE
To describe the association between gastric residual volumes and aspiration of gastric contents.


METHODS
In a prospective study of 206 critically ill patients receiving gastric tube feedings for 3 consecutive days, gastric residual volumes were measured with 60-mL syringes every 4 hours. Measured volumes were categorized into 3 overlapping groups: at least 150 mL, at least 200 mL, and at least 250 mL. Patients were categorized as frequent aspirators if 40% or more of their tracheal secretions were positive for pepsin and as infrequent aspirators if less than 40% of their secretions were positive for pepsin. Gastric residual volumes were compared between the 2 aspiration groups.


RESULTS
Approximately 39% of the 206 patients had 1 or more gastric residual volumes of at least 150 mL, 27% had 1 or more volumes of at least 200 mL, and 17% had 1 or more volumes of at least 250 mL. Large-bore tubes identified most of the high volumes. Eighty-nine patients were frequent aspirators. Volumes less than 150 mL were common in both aspiration groups. However, the frequent aspirators had a significantly greater frequency of 2 or more volumes of at least 200 mL and 1 or more volumes of at least 250 mL.


CONCLUSIONS
No consistent relationship was found between aspiration and gastric residual volumes. Although aspiration occurs without high gastric residual volumes, it occurs significantly more often when volumes are high.
Metheny
Norma A
NA
Saint Louis University School of Nursing, St Louis, Missouri 63104-1099, USA. methenna@slu.edu
Schallom
Lynn
L
Oliver
Dana A
DA
Clouse
Ray E
RE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness; D004750:Enteral Nutrition / Q000009:adverse effects*; D005260:Female; D005746:Gastric Emptying; D005766:Gastrointestinal Contents; D006304:Health Status; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D053120:Respiratory Aspiration / Q000209:etiology*; D055815:Young Adult