Investigating Inappropriate Discontinuations of Enteral Nutrition Related to Gastric Residual Volume in Critically Ill Patients: A Retrospective Observational Descriptive Study

Authors

  • Gen Aikawa, RN, PhD Department of Adult Health Nursing, College of Nursing, Ibaraki Christian University, Hitachi, Ibaraki, Japan https://orcid.org/0000-0002-7404-5442
  • Daiki Nobushima, RN Atto Fukuiro Co., Ltd., Ichihara, Chiba, Japan
  • Takahiro Hiki, RN Intensive care unit, University of Tsukuba Hospital, Ibaraki, Japan
  • Hideaki Sakuramoto, RN, PhD Department of Critical Care and Disaster Nursing, Japanese Red Cross Kyushu International College of Nursing, Asty, Munakata, Fukuoka, Japan
  • Takeshi Unoki, RN, PhD Department of Acute and Critical Care Nursing, School of Nursing, Sapporo City University, Sapporo, Japan https://orcid.org/0000-0002-7778-4355

DOI:

https://doi.org/10.29173/ijcc129

Keywords:

gastric residual volume, enteral tube feeding, enteral nutrition, discontinuation, critically ill, intensive care

Abstract

Background: Gastric residual volume (GRV) is measured by nurses in clinical practice as a simple method to assess gastrointestinal intolerance. Nutrition therapy guidelines recommend avoiding enteral tube feeding (ETF) discontinuation if GRV is < 500 mL.

Aim: This study aimed to clarify the status of inappropriate ETF discontinuation related to GRV in critically ill patients.

Methods: Patients who were ventilated for more than 48 hours in the intensive care unit of a university hospital in 2021 were retrospectively surveyed, and data were collected up to 2 weeks after admission. ETF discontinuation data were collected and categorized as planned or unplanned. The reasons for unplanned discontinuation were further categorized into high GRV, symptoms, and conditions. The reasons and the amount of GRV were analyzed descriptively. Inappropriate ETF discontinuation related to GRV was defined as ETF discontinuation for a GRV of < 500 mL.

Results: ETF was discontinued in 10% (270 events / 2,600 orders) of critically ill patients. Unplanned discontinuations accounted for 37% (99/270) of discontinuations, with GRV being the most common reason (43%), followed by nausea and vomiting (8%), and hemodynamic instability (8%).

Conclusions: Thirty-seven percent of ETF discontinuations in critically ill patients were unplanned, and 42% of these were inappropriate ETF discontinuations related to GRV. Research results and guideline recommendations need to be disseminated clearly to make more healthcare providers aware of the GRV criteria for discontinuing ETFs.

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Published

2024-11-01

How to Cite

Aikawa, G., Nobushima, D., Hiki, T., Sakuramoto, H., & Unoki, T. (2024). Investigating Inappropriate Discontinuations of Enteral Nutrition Related to Gastric Residual Volume in Critically Ill Patients: A Retrospective Observational Descriptive Study. International Journal of Critical Care, 18(3), 22–33. https://doi.org/10.29173/ijcc129

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