Use of Residual Volume as a Marker for Enteral Feeding Intolerance: Prospective Blinded Comparison With Physical Examination and Radiographic Findings

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Abstract
High gastric residual volumes (RVs) are a frequent cause for cessation of total enteral nutrition (TEN). This study was designed to determine the RV that indicates intolerance or inadequate gastric emptying and to compare the RV findings in a blinded fashion with those findings obtained on physical examination and radiography. Twenty healthy normal volunteers (HNV), 8 stable patients with gastrostomy tubes (GTP), and 10 critically ill patients (CIP) were evaluated prospectively for 8 hours while receiving TEN. No subjects were clearly intolerant (ie, vomiting, aspiration). Of the total RVs recorded, 13.1% were ≥150 mL in the CIP group, whereas only 2.4% of the RVs were ≥150 mL in the HNV group. None of the RVs in the GTP group were ≥150 mL. Objective scores on physical examination failed to correlate with RV (p =.397), as did objective scores on radiography (p =.742). However, objective scores on physical examination were significantly related to scores on radiography (p =.016). Abnormal physical examination findings were found in 4 out of 11 patients (GTP + CIP) with RVs (Journal of Parenteral and Enteral Nutrition 16:99—105, 1992)

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