Current practice of gastric residual volume measurements and related outcomes of critically ill patients - a secondary analysis of the iSOFA study

BACKGROUND

Gastric residual volumes (GRV) measurement to detect gastrointestinal (GI) dysfunction is one of the most common diagnostic procedures in critical care, albeit still not well standardized being operator-, patient-, and tube-dependent. Our aim was to describe current practice of GRV measurements and its association with clinical outcomes in a mixed cohort of adult critically ill patients.

METHODS

This was a secondary analysis of an international prospective observational cohort study (iSOFA). Eligibility criteria were defined as ≥ 1 GRV measurement during the 7-day study period. Data collection included GRV measurement practices, tube diameters and volumes, symptoms of GI dysfunction, and clinical outcomes. The primary aim was to describe current practices of GRV measurements, secondary aim was to test the association of high (> 200 ml) vs. low GRV with symptoms of GI dysfunction and clinical outcomes using generalized linear regression and survival models.

RESULTS

258 patients with 2422 GRV measurements on 875 study days were analyzed. GRV was mainly measured via passive drainage twice daily using large diameter tubes. There was no significant association between tube size or measurement technique and high GRV. High GRV occurred in 34% of patients and was associated with other GI symptoms and with increased disease severity, but not with 28-day, 90-day mortality, ICU free or ventilator free days.

CONCLUSION

There was substantial variability of GRV measurement techniques, but this had no impact on the amount of GRV. High GRV was not associated with mortality or ventilator free days, but may serve as a marker of GI dysfunction and disease severity. This article is protected by copyright. All rights reserved.