title: Abdominal circumference or gastric residual volume as measure of feed intolerance in VLBW infants.
abstract: BACKGROUND
  The aim of the study was to compare prefeed abdominal circumference (AC) and gastric residual volume (GRV) as a measure of feed intolerance in very-low-birth-weight infants (VLBW).
  
  
  METHODS
  Eighty VLBW infants were randomized to 2 groups; feed intolerance was monitored by measuring either GRV group or prefeed AC group. The primary outcome was time to full enteral feeds (180 mL · kg · day). Other main outcome measures were feed interruption days, duration of parenteral nutrition, incidence of culture positive sepsis, necrotizing enterocolitis, mortality, and duration of hospital stay.
  
  
  RESULTS
  The median (interquartile range) time to achieve full feeds was 10 (9-13) versus 14 (12-17.5) days in AC and GRV groups, respectively (P < 0.001). Infants in AC group had fewer feed interruption days (0 [0-2] vs 2.0 [1, 5], P < 0.001) and shorter duration of parenteral nutrition (P < 0.001). The incidence of culture-positive sepsis in AC and GRV groups was 17.5% and 30 %, respectively (P = 0.18). Duration of hospital stay and mortality were comparable in both the groups.
  
  
  CONCLUSIONS
  Prefeed AC as a measure of feed intolerance in VLBW infants may shorten the time taken to achieve full feeds.
authors.affiliation: Department of Neonatology, Institute of Child health, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Avneet
authors.initials: A
authors.lastname: Kaur
authors.forename: Neelam
authors.initials: N
authors.lastname: Kler
authors.forename: Satish
authors.initials: S
authors.lastname: Saluja
authors.forename: Manoj
authors.initials: M
authors.lastname: Modi
authors.forename: Arun
authors.initials: A
authors.lastname: Soni
authors.forename: Anup
authors.initials: A
authors.lastname: Thakur
authors.forename: Pankaj
authors.initials: P
authors.lastname: Garg
mesh_terms: D004750:Enteral Nutrition / Q000379:methods*; D020345:Enterocolitis, Necrotizing / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007902:Length of Stay; D008297:Male; D010288:Parenteral Nutrition / Q000009:adverse effects; D018805:Sepsis / Q000382:microbiology / Q000401:mortality; D013270:Stomach; D013997:Time Factors; D016896:Treatment Outcome; D055105:Waist Circumference