title: A randomised trial of re-feeding gastric residuals in preterm infants.
abstract: OBJECTIVE
  To determine whether re-feeding of gastric residual volumes reduces the time needed to achieve full enteral feeding in preterm infants.
  
  
  METHODS
  Parallel-group randomised controlled trial with a 1:1 allocation ratio.
  
  
  METHODS
  Regional referral neonatal intensive care unit.
  
  
  METHODS
  72 infants of gestational age 23(0/7) to 28(6/7) weeks receiving minimal enteral nutrition (<24 mL/kg/day) during the first week after birth.
  
  
  METHODS
  Infants were randomised to either be re-fed with gastric residual volumes (Re-feeding group) or receive fresh formula/human milk (Fresh-feeding group) whenever large gastric residual volumes were noted.
  
  
  METHODS
  The primary efficacy end point was time to achieve full enteral feeding (≥120 mL/kg/day) after randomisation.
  
  
  RESULTS
  The mean time to full enteral feeding was 10.0 days in the Re-feeding group and 11.3 days in the Fresh-feeding group (mean difference favouring re-feeding: -1.3 days; 95% CI -2.9 to 0.3; p=0.11). The composite safety end point of spontaneous intestinal perforation, surgical necrotising enterocolitis, or death occurred in 6 of 36 infants (17%) in the Re-feeding group versus 10 of 36 infants (28%) in the Fresh-feeding group (p=0.26).
  
  
  CONCLUSIONS
  Re-feeding gastric residual volumes in extremely preterm infants does not reduce time to achieve full enteral feeding. This trial suggests that re-feeding might be as safe as fresh feeding, but further research is needed, due to lack of sufficient statistical power in this study for safety analysis.
  
  
  BACKGROUND
  NCT01420263NCT01420263.
authors.affiliation: Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Ariel A
authors.initials: AA
authors.lastname: Salas
authors.affiliation: Department of Pediatrics, University of Missouri-Kansas City, Kansas City, Missouri, USA.
authors.forename: Alain
authors.initials: A
authors.lastname: Cuna
authors.affiliation: Department of Pediatrics, University of Maryland, Baltimore, Maryland, USA.
authors.forename: Ramachandra
authors.initials: R
authors.lastname: Bhat
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
authors.affiliation: Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Waldemar A
authors.initials: WA
authors.lastname: Carlo
authors.affiliation: Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Namasivayam
authors.initials: N
authors.lastname: Ambalavanan
mesh_terms: D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D020345:Enterocolitis, Necrotizing / Q000175:diagnosis; D005260:Female; D005766:Gastrointestinal Contents; D006801:Humans; D007223:Infant; D041943:Infant Formula; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007416:Intestinal Perforation / Q000175:diagnosis; D008297:Male; D008895:Milk, Human; D066087:Perinatal Death; D012307:Risk Factors
keywords: Infant Feeding; Neonatology