Measuring gastric residual volumes in critically ill burn patients - A systematic review.
Burns
; 45(3): 509-525, 2019 05.
Article
in En
| MEDLINE
| ID: mdl-29914737
ABSTRACT
PURPOSE:
Measuring gastric residual volumes (GRV) is common in intensive care units (ICU) in patients receiving enteral nutrition (EN) and are a common source of feeding interruptions. Interruptions in EN yield adverse outcomes and are an area of improvement in burn care. The objectives of this study are to summarize the literature's ICU GRV practices and offer practical suggestions to GRV management in the burn patient.METHODS:
PubMed, SCOPUS, and OvidSP Medline were systematically reviewed using the keywords burns; thermal injury; gastric residual volume; enteral feeding; tube feeding; enteral nutrition; gastric intolerance; ICU; critical illness. Reviews, case reports, and consensus and opinion papers were excluded.RESULTS:
26 articles were identified. Six burn-specific studies were identified. GRV practices vary widely and are a common cause of EN interruption. Elevated GRVs do not equate to gastrointestinal intolerance and do not always reflect aspiration risk.CONCLUSIONS:
We advocate a GRV threshold of 500mL should be used to optimize the benefits of EN in burn ICUs. A single incident of elevated GRVs should not mandate immediate EN rate reduction or cessation but should prompt a thoughtful examination of secondary causes of gastrointestinal intolerance. Randomized controlled trials are needed to define the ideal GRV threshold and re-evaluate its role in burn care.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Stomach
/
Burns
/
Enteral Nutrition
/
Respiratory Aspiration
/
Gastric Emptying
Type of study:
Clinical_trials
/
Systematic_reviews
Limits:
Humans
Language:
En
Journal:
Burns
Journal subject:
TRAUMATOLOGIA
Year:
2019
Document type:
Article
Affiliation country:
Estados Unidos