title: Frequency of aspirating gastric tubes for patients receiving enteral nutrition in the ICU: a randomized controlled trial.
abstract: BACKGROUND
  Enteral nutrition (EN) tolerance is often monitored by aspirating stomach contents by syringe at prescribed intervals. No studies have been conducted to assess the most appropriate time interval for aspirating gastric tubes. We compared gastric tube aspirations every 4 hours (usual care) with a variable regimen (up to every 8 hours aspirations).
  
  
  METHODS
  This randomized controlled trial (RCT) enrolled patients who stayed in the intensive care unit (ICU) for >48 hours, had a gastric tube, and were likely to receive EN for 3 or more days. Patients were randomized (computer-generated randomization) to either the control (every 4 hours) or intervention group (variable regimen). The primary outcome was number of gastric tube aspirations per day from randomization until EN was ceased or up to 2 weeks postrandomization.
  
  
  RESULTS
  Following Institutional Ethics Committee approval, 357 patients were recruited (control group, n = 179; intervention group, n = 178). No differences were found in age, sex, worst APACHE II score, or time to start of EN. In the intention-to-treat analysis, the intervention group had fewer tube aspirations per day (3.4 versus 5.4 in the control group, P < .001). Vomiting/regurgitation was increased in the intervention group (2.1% versus 3.6%, P = .02). There were no other differences in complications.
  
  
  CONCLUSIONS
  This is the first RCT to examine the frequency of gastric tube aspirations. The frequency of gastric tube aspirations was reduced in the variable-regimen group with no increase in risk to the patient. Reducing the frequency of aspirations saves nursing time, decreases risk of contamination of feeding circuit, and minimizes risk of body fluid exposure.
authors: Prehospital Resuscitation and Emergency Care Research Unit, Faculty of Health Sciences, Curtin University and Research Fellow, ICU Royal Perth Hospital, Bentley, Western Australia Intensive Care Unit, Royal Perth Hospital, Perth, Western Australia Teresa.williams@curtin.edu.au.
authors: Teresa A
authors: TA
authors: Williams
authors: School of Nursing & Midwifery, Curtin Health Innovation Research Institute, Faculty Health Science, Curtin University, Perth, Western Australia.
authors: Gavin
authors: G
authors: Leslie
authors: Intensive Care Unit, Royal Perth Hospital, Perth, Western Australia.
authors: Lauren
authors: L
authors: Mills
authors: Intensive Care Unit, Royal Perth Hospital, Perth, Western Australia.
authors: Tim
authors: T
authors: Leen
authors: Intensive Care Unit, Royal Perth Hospital, Perth, Western Australia.
authors: Hugh
authors: H
authors: Davies
authors: Intensive Care Unit, Royal Perth Hospital, Perth, Western Australia.
authors: David
authors: D
authors: Hendron
authors: Intensive Care Unit, Royal Perth Hospital, Perth, Western Australia School of Medicine and Pharmacology, The University of Western Australia, Crawley, Western Australia.
authors: Geoffrey J
authors: GJ
authors: Dobb
mesh_terms: D000328:Adult; D000368:Aged; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D057194:Intention to Treat Analysis; D007441:Intubation, Gastrointestinal / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D014839:Vomiting / Q000209:etiology
keywords: enteral feeding tube; enteral nutrition; gastric residual volume; nasogastric tube