Gastric Residual Volume Measurement in U.K. PICUs: A Survey of Practice.

Autor:	Tume LN; Child Health, Faculty of Health & Applied Sciences, University of the West of England, Bristol, United Kingdom., Arch B; Medicines for Children Clinical Trials Unit, Clinical Trials Research Centre, University of Liverpool Institute of Child Health Alder Hey Children's NHS Foundation Trust Liverpool, Liverpool, United Kingdom., Woolfall K; Department of Health Services Research, MRC Hubs for Trials Methodology Research, University of Liverpool, Liverpool, United Kingdom., Latten L; Department of Dietetics, Alder Hey Children's Hospital, Liverpool, United Kingdom., Deja E; Department of Health Services Research, University of Liverpool, Liverpool, United Kingdom., Roper L; Department of Health Services Research, University of Liverpool, Liverpool, United Kingdom., Pathan N; Paediatric Intensive Care, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom., Eccleson H; Medicines for Children Clinical Trials Unit, Clinical Trials Research Centre, University of Liverpool Institute of Child Health Alder Hey Children's NHS Foundation Trust Liverpool, Liverpool, United Kingdom., Hickey H; Medicines for Children Clinical Trials Unit, Clinical Trials Research Centre, University of Liverpool Institute of Child Health Alder Hey Children's NHS Foundation Trust Liverpool, Liverpool, United Kingdom., Brown M; Medicines for Children Clinical Trials Unit, Clinical Trials Research Centre, University of Liverpool Institute of Child Health Alder Hey Children's NHS Foundation Trust Liverpool, Liverpool, United Kingdom., Beissel A; Neonatal Intensive Care Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon-Bron, France., Andrzejewska I; Neonatal Unit/Neonatal, Chelsea and Westminster Hospital, London, United Kingdom., Gale C; Neonatal Medicine, Imperial College London, Chelsea and Westminster Hospital campus, London, United Kingdom., Valla FV; Pediatric Intensive Care Unit, CarMEN INSERM UMR 1060 Equipe INFOLIP, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon-Bron, France.; Faculty of Health & Applied Sciences, University of the West of England, Bristol, United Kingdom., Dorling J; Division of Pediatrics and Neonatal-Perinatal Medicine, Dalhousie University and IWK Health Centre, Halifax, NS, Canada.
Jazyk:	angličtina
Zdroj:	Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies [Pediatr Crit Care Med] 2019 Aug; Vol. 20 (8), pp. 707-713.
DOI:	10.1097/PCC.0000000000001944
Abstrakt:	Objectives: Despite little evidence, the practice of routine measurement of gastric residual volume to guide both the initiation and delivery of enteral feeding in PICUs is widespread internationally. In light of increased scrutiny of the evidence surrounding this practice, and as part of a trial feasibility study, we aimed to determine enteral feeding and gastric residual volume measurement practices in U.K. PICUs. Design: An online survey to 27 U.K. PICUs. Setting: U.K. PICUs. Subjects: A clinical nurse, senior doctor, and dietician were invited to collaboratively complete one survey per PICU and send a copy of their unit guidelines on enteral feeding and gastric residual volume. Interventions: None. Measurement and Main Results: Twenty-four of 27 units (89%) approached completed the survey. Twenty-three units (95.8%; 23/24) had written feeding guidelines, and 19 units (19/23; 83%) sent their guidelines for review. More units fed continuously (15/24; 62%) than intermittently (9/24; 37%) via the gastric route as their primary feeding method. All but one PICU routinely measured gastric residual volume, regardless of the method of feeding. Eighteen units had an agreed definition of feed tolerance, and all these included gastric residual volume. Gastric residual volume thresholds for feed tolerance were either volume based (mL/kg body weight) (11/21; 52%) or a percentage of the volume of feed administered (6/21; 29%). Yet only a third of units provided guidance about the technique of gastric residual volume measurement. Conclusions: Routine gastric residual volume measurement is part of standard practice in U.K. PICUs, with little guidance provided about the technique which may impact the accuracy of gastric residual volume. All PICUs that defined feed tolerance included gastric residual volume in the definition. This is important to know when proposing a standard practice arm of any future trial of no-routine gastric residual volume measurement in critically ill children.
Databáze:	MEDLINE
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