Though the residual gastric volume is typically measured in patients on mechanical ventilation who receive nutrition through a feeding tube, the lack of this monitoring did not significantly increase the patient’s risk of developing ventilator-associated pneumonia (VAP), according to research in the current issue of JAMA. The practice may actually result in inadequate feeding, researchers found, because the monitoring of residual gastric volume leads to unnecessary interruptions of use of the feeding tube.
For the randomized, noninferiority trial investigators found that VAP occurred in 38 of 227 patients (16.7%) in the group that did not receive residual gastric volume monitoring (the “intervention group”), compared to 35 of 222 patients (15.8%) in the control group. Additionally, those in the intervention group were 77% more likely to receive 100% of their calorie goal than control patients.
“The current study supports the hypothesis that a protocol of enteral nutrition management without residual gastric volume monitoring is not inferior to a similar protocol including residual gastric volume monitoring in terms of protection against VAP,” the authors conclude. “Residual gastric volume monitoring leads to unnecessary interruptions of enteral nutrition delivery with subsequent inadequate feeding and should be removed from the standard care of critically ill patients receiving invasive mechanical ventilation and early enteral nutrition.”
