Effects of Different Gastric Residual Volume Thresholds on Morbidity and Mortality in Patients Receiving Intensive Care

Objective:Enteral feeding is often limited by gastrointestinal intolerance. However, there is no consensus on the threshold value of gastric residual volume (GRV) on adjusting the enteral feeding rate. This study aimed to determine the effects of GRV thresholds of 150 mL and 250 mL on reaching calor...

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Autores principales:	Esra Çankaya, Sertaç Çankaya, Ahmet Oğuzhan Küçük, Hülya Ulusoy
Formato:	article
Lenguaje:	EN TR
Publicado:	Galenos Yayinevi 2021
Materias:	calories enteral nutrition gastric residual volume intensive care protein Medicine R Internal medicine RC31-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/0621d12966194527b17d02ebea126c9d
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spelling	oai:doaj.org-article:0621d12966194527b17d02ebea126c9d2021-11-23T10:33:41ZEffects of Different Gastric Residual Volume Thresholds on Morbidity and Mortality in Patients Receiving Intensive Care2146-64162147-267X10.4274/tybd.galenos.2020.39974https://doaj.org/article/0621d12966194527b17d02ebea126c9d2021-12-01T00:00:00Z http://www.turkishjic.org/archives/archive-detail/article-preview/effects-of-different-gastric-residual-volume-thres/43201 https://doaj.org/toc/2146-6416https://doaj.org/toc/2147-267XObjective:Enteral feeding is often limited by gastrointestinal intolerance. However, there is no consensus on the threshold value of gastric residual volume (GRV) on adjusting the enteral feeding rate. This study aimed to determine the effects of GRV thresholds of 150 mL and 250 mL on reaching calorie and protein targets and to determine gastric intolerance in patients receiving intensive care and enteral feeding.Materials and Methods:In this retrospective study, patients who were treated and followed in the intensive care unit (ICU) of our clinic between 2008 and 2017 were examined for 14 days after hospitalisation. Caloric values, protein values, presence of gastric intolerance, morbidity, and mortality factors of the patients, who were divided into two groups with 150 mL (group 1) and 250 mL (group 2) GRV thresholds, were examined.Results:The amounts of calories and proteins provided after 14 days were significantly higher in group 2 (p<0.001), and the cumulative calorie and protein deficits were significantly less in group 2 (p<0.001). As regards morbidity and mortality, no significant difference was observed in aspiration pneumonia, anaemia, disseminated intravascular coagulation, septic shock, reintubation, intensive care mortality, 28th day mortality, and number of mechanical ventilation-free days between the two groups. The incidence of nosocomial infection (p=0.002) and ventilator-associated pneumonia (p<0.001) was significantly higher and the duration of mechanical ventilation (p<0.001) and length of stay in the ICU (p<0.001) was significantly longer in group 2 than in group 1. No statistically significant difference was observed between the two groups in terms of the development of gastrointestinal intolerance during follow-up (p=0.896).Conclusion:Target nutritional values were reached in both groups. No pathological side effects of excessive intervention were observed in the group with lower tolerance. Similarly, no valuable morbidity or mortality result was obtained for the 250 mL threshold.Esra ÇankayaSertaç ÇankayaAhmet Oğuzhan KüçükHülya UlusoyGalenos Yayineviarticlecaloriesenteral nutritiongastric residual volumeintensive careproteinMedicineRInternal medicineRC31-1245Medical emergencies. Critical care. Intensive care. First aidRC86-88.9ENTRTürk Yoğun Bakim Derneği Dergisi, Vol 19, Iss 4, Pp 158-166 (2021)
institution	DOAJ
collection	DOAJ
language	EN TR
topic	calories enteral nutrition gastric residual volume intensive care protein Medicine R Internal medicine RC31-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	calories enteral nutrition gastric residual volume intensive care protein Medicine R Internal medicine RC31-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Esra Çankaya Sertaç Çankaya Ahmet Oğuzhan Küçük Hülya Ulusoy Effects of Different Gastric Residual Volume Thresholds on Morbidity and Mortality in Patients Receiving Intensive Care
description	Objective:Enteral feeding is often limited by gastrointestinal intolerance. However, there is no consensus on the threshold value of gastric residual volume (GRV) on adjusting the enteral feeding rate. This study aimed to determine the effects of GRV thresholds of 150 mL and 250 mL on reaching calorie and protein targets and to determine gastric intolerance in patients receiving intensive care and enteral feeding.Materials and Methods:In this retrospective study, patients who were treated and followed in the intensive care unit (ICU) of our clinic between 2008 and 2017 were examined for 14 days after hospitalisation. Caloric values, protein values, presence of gastric intolerance, morbidity, and mortality factors of the patients, who were divided into two groups with 150 mL (group 1) and 250 mL (group 2) GRV thresholds, were examined.Results:The amounts of calories and proteins provided after 14 days were significantly higher in group 2 (p<0.001), and the cumulative calorie and protein deficits were significantly less in group 2 (p<0.001). As regards morbidity and mortality, no significant difference was observed in aspiration pneumonia, anaemia, disseminated intravascular coagulation, septic shock, reintubation, intensive care mortality, 28th day mortality, and number of mechanical ventilation-free days between the two groups. The incidence of nosocomial infection (p=0.002) and ventilator-associated pneumonia (p<0.001) was significantly higher and the duration of mechanical ventilation (p<0.001) and length of stay in the ICU (p<0.001) was significantly longer in group 2 than in group 1. No statistically significant difference was observed between the two groups in terms of the development of gastrointestinal intolerance during follow-up (p=0.896).Conclusion:Target nutritional values were reached in both groups. No pathological side effects of excessive intervention were observed in the group with lower tolerance. Similarly, no valuable morbidity or mortality result was obtained for the 250 mL threshold.
format	article
author	Esra Çankaya Sertaç Çankaya Ahmet Oğuzhan Küçük Hülya Ulusoy
author_facet	Esra Çankaya Sertaç Çankaya Ahmet Oğuzhan Küçük Hülya Ulusoy
author_sort	Esra Çankaya
title	Effects of Different Gastric Residual Volume Thresholds on Morbidity and Mortality in Patients Receiving Intensive Care
title_short	Effects of Different Gastric Residual Volume Thresholds on Morbidity and Mortality in Patients Receiving Intensive Care
title_full	Effects of Different Gastric Residual Volume Thresholds on Morbidity and Mortality in Patients Receiving Intensive Care
title_fullStr	Effects of Different Gastric Residual Volume Thresholds on Morbidity and Mortality in Patients Receiving Intensive Care
title_full_unstemmed	Effects of Different Gastric Residual Volume Thresholds on Morbidity and Mortality in Patients Receiving Intensive Care
title_sort	effects of different gastric residual volume thresholds on morbidity and mortality in patients receiving intensive care
publisher	Galenos Yayinevi
publishDate	2021
url	https://doaj.org/article/0621d12966194527b17d02ebea126c9d
work_keys_str_mv	AT esracankaya effectsofdifferentgastricresidualvolumethresholdsonmorbidityandmortalityinpatientsreceivingintensivecare AT sertaccankaya effectsofdifferentgastricresidualvolumethresholdsonmorbidityandmortalityinpatientsreceivingintensivecare AT ahmetoguzhankucuk effectsofdifferentgastricresidualvolumethresholdsonmorbidityandmortalityinpatientsreceivingintensivecare AT hulyaulusoy effectsofdifferentgastricresidualvolumethresholdsonmorbidityandmortalityinpatientsreceivingintensivecare
_version_	1718416746249977856

Effects of Different Gastric Residual Volume Thresholds on Morbidity and Mortality in Patients Receiving Intensive Care

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