Should We Stop Using Gastric Residual Volumes?

Sarah Diamond, Valentina Medici, Todd W. Rice, Keith Miller

Research output: Contribution to journalReview article

Abstract

Early enteral nutrition support is an important component in the management of critically ill patients. However, gastrointestinal tolerance and gastric motility are frequently impaired in this population. Intolerance of enteral nutrition may present clinically as vomiting, aspiration, and abdominal distension. Concerns for the association between gastrointestinal intolerance and the development of ventilator-associated pneumonia have historically led to close monitoring of patients’ tolerance of enteral feeding using various metrics. The measurement of gastric residual volumes (GRV) is the most commonly used surrogate marker for gastrointestinal intolerance in intensive care units. As the name implies, GRV is the volume of enteral formula remaining in a patient’s stomach after cessation of enteral nutrition at various, predetermined time intervals. Despite the logical rationale, there is increasing evidence that monitoring gastric residual volumes may not improve patient outcomes in the critically ill. In this review, we will describe the components of normal gastric motor physiology and review abnormal physiology and dysfunction observed during critical illness. Finally, we will examine the evidence that both supports and refutes the routine use of gastric residual volumes and suggest specific recommendations about the future utilization of this practice.

Original languageEnglish (US)
Pages (from-to)236-241
Number of pages6
JournalCurrent Nutrition Reports
Volume4
Issue number3
DOIs
StatePublished - Sep 3 2015

Fingerprint

Residual Volume
Stomach
stomach
enteral feeding
Enteral Nutrition
Critical Illness
physiology
ventilators
gastrointestinal motility
monitoring
Ventilator-Associated Pneumonia
vomiting
Physiologic Monitoring
pneumonia
Small Intestine
Names
Vomiting
Intensive Care Units
Biomarkers
Population

Keywords

  • Enteral nutrition
  • Gastric dysmotility
  • Gastric residual volume
  • GRV

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics

Cite this

Should We Stop Using Gastric Residual Volumes? / Diamond, Sarah; Medici, Valentina; Rice, Todd W.; Miller, Keith.

In: Current Nutrition Reports, Vol. 4, No. 3, 03.09.2015, p. 236-241.

Research output: Contribution to journalReview article

Diamond, Sarah ; Medici, Valentina ; Rice, Todd W. ; Miller, Keith. / Should We Stop Using Gastric Residual Volumes?. In: Current Nutrition Reports. 2015 ; Vol. 4, No. 3. pp. 236-241.
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