Should we be checking gastric residuals in premature infants?
With Dr. Arun Thanain · StayCurrentMD
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Evaluating gastric residuals has been standard of care in most NICUs probably for decades
There doesn't really seem to be much supporting evidence in the literature for checking gastric residuals
High gastric residuals were presumed to be a risk for aspiration or ventilator associated pneumonia
Gastric residuals were thought to be an early sign of necrotizing enterocolitis
The Parker et al. study was a prospective randomized control trial in a level 4 NICU with about 140 patients
Half the group continued to check gastric residuals right before each feeding and the other group stopped checking them
Babies were followed for 6 weeks to determine how quickly they increased feeding on a daily and weekly basis
The group in which they didn't check gastric residuals advanced feeds much quicker
The no-check group got to full feeds quicker, usually by 5 weeks
The no-check group got discharged from the NICU about 8 days earlier on average
There was no difference in odds of developing necrotizing enterocolitis or ventilator associated pneumonia between the two groups
The study excluded babies that had any GI conditions or cardiac disease or were post-op
Study subjects were very low birth weight infants who might be on the ventilator or have respiratory issues but were otherwise fine