Current practice of gastric residual volume measurements and related outcomes of critically ill patients: a secondary analysis of the intestinal-specific organ function assessment study
Open accessAbstract
Background: Gastric residual volume (GRV) measurement to detect gastrointestinal (GI) dysfunction is a 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 critically ill patients. Methods: This was a secondary analysis of an international prospective observational cohort study (intestinal‐specific organ function assessment). 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, and the 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: Two hundred fifty‐eight 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 or 90‐day mortality, intensive care unit‐free and 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.
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Routine monitoring of gastric residuals does not decrease aspiration risk.
“Routine monitoring of gastric residuals is no longer recommended because it does not decrease aspiration risk and can result in underfeeding.134,142–144”
From Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association (2026) · cites this paper as [143]
Routine monitoring of gastric residuals can result in underfeeding.
“Routine monitoring of gastric residuals is no longer recommended because it does not decrease aspiration risk and can result in underfeeding.134,142–144”
From Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association (2026) · cites this paper as [143]
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- Authors
- Lindner, M., Padar, M., Mändul, M., Christopher, K. B., Reintam Blaser, A., Gratz, H., Elke, G., & Bachmann, K. F.
- Affiliations
- University Hospital Schleswig-Holstein (DE)
- University of Tartu (EE)
- Brigham and Women's Hospital (US)
- Department of Anaesthesiology and Intensive Care University of Tartu Tartu Estonia
- Luzerner Kantonsspital (CH)
- Corresponding author
- Lindner, Matthias
- ORCID
- Venue
- Journal of Parenteral and Enteral Nutrition
- Publisher
- Wiley
- Published
- 2023-04-26
- Volume
- 47
- Issue
- 5
- Pages
- 614-623
- ISSN
- 0148-6071 (ISSN-L)
- 1941-2444
- OpenAlex
- W4361190099
- Cited by
- 22
- References
- 36
- Citations by year
- 2026: 10 · 2025: 5 · 2024: 4 · 2023: 3
- FWCI
- 3.86
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Parenteral and Enteral Nutrition (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Multimedialen Archiv und Publikationsserver der Christian-Albrechts-Universität zu Kiel (Christian-Albrechts-Universität zu Kiel) (submittedVersion, cc-by-nc)
- Funders
- Eesti Teadusagentuur (PRG1255)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Keywords
- gastric residual volume, gastrointestinal dysfunction, critically ill patients, enteral nutrition, tube diameter, disease severity, mortality, ventilator-free days
- MeSH terms
- Enteral Nutrition, Gastrointestinal Diseases, Humans, Prospective Studies, Residual Volume, Stomach, Critical Illness
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