title: Gastric residual evaluation in preterm neonates: a useful monitoring technique or a hindrance?
abstract: It is routine practice in most neonatal intensive care units to measure the volume and color of gastric residuals (GRs) prior to enteral bolus feedings in preterm very low birth weight infants. However, there is paucity of evidence supporting the routine use of this technique. Moreover, owing to the lack of uniform standards in the management of GRs, wide variations exist as to what constitutes significant GR volume, the importance of GR color and frequency of GR evaluation, and the color or volume standards that dictate discarding or returning GRs. The presence of large GR volumes or green-colored residuals prior to feeding often prompts subsequent feedings to be withheld or reduced because of possible necrotizing enterocolitis resulting in delays in enteral feeding. Cessation or delays in enteral feeding may result in extrauterine growth restriction, a known risk factor for poor neurodevelopmental and growth outcomes in preterm very low birth weight infants. Although some neonatal intensive care units are abandoning the practice of routine GR evaluation, little evidence exists to support the discontinuation or continuation of this practice. This review summarizes the current state of GR evaluation and underlines the need for a scientific basis to either support or refute the routine evaluation of GRs.
authors.affiliation: Department of Neonatology, Bao'an Maternity and Child Health Hospital of Shenzhen, Shenzhen, Guangdong, China.
authors.forename: Yue-Feng
authors.initials: YF
authors.lastname: Li
authors.affiliation: Department of Pediatrics and School of Chinese Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan.
authors.forename: Hung-Chih
authors.initials: HC
authors.lastname: Lin
authors.affiliation: Department of Pediatrics, Division of Neonatology, University of Florida, Gainesville, FL, USA.
authors.forename: Roberto Murgas
authors.initials: RM
authors.lastname: Torrazza
authors.affiliation: College of Nursing, University of Florida, Gainesville, FL, USA.
authors.forename: Leslie
authors.initials: L
authors.lastname: Parker
authors.affiliation: Shands at the University of Florida, Gainesville, FL, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Talaga
authors.affiliation: Department of Pediatrics, Division of Neonatology, University of Florida, Gainesville, FL, USA. Electronic address: neuj@peds.ufl.edu.
authors.forename: Josef
authors.initials: J
authors.lastname: Neu
mesh_terms: D004750:Enteral Nutrition; D020345:Enterocolitis, Necrotizing / Q000175:diagnosis; D005746:Gastric Emptying; D005766:Gastrointestinal Contents; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D007235:Infant, Premature, Diseases / Q000175:diagnosis; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D007363:Intensive Care Units, Neonatal; D008991:Monitoring, Physiologic
keywords: gastric residual volume; gastric residuals; nasogastric/orogastric; necrotizing enterocolitis; preterm very low birth weight