GASTRIC RESIDUAL VOLUME
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MONITORING:-
Patients
on tube feeding are at risk for fluid imbalance, gut dysfunction,and
electrolyte imbalance.Refeeding syndrome is often seen in chronically under nourished
patients,especially those with
electrolyte losses such as diarrhea,vomiting or renal wasting.
It
has long been standard clinical practice to check the patients gastric residual
volume[GRV] at regular intervals and / or prior to increasing the infusion rate
of gastric tube feeding. This was done based on the theory that the risk of
pneumonia would be minimized by recognizing gastric fluid accumulation and
therefore predicting and reducing vomiting. However, this practice has now been
shown to lack benefit, and is no longer recommended .If GRV is measured,
volumes of less than 500ml should not result in the holding of the feeds unless
other signs of intolerance, such as distension, nausea /vomiting are present.
Studies
have shown that measurement of gastric residuals correlates poorly with
aspiration risk and is associated with a decrease in calorie delivery.
Referance:-
www.uptodate.com/nutrition-supports-in-critically-ill-patients
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