Gastric Residual Volume in Feeding Advancement in Preterm Infants (GRIP Study): A Randomized Trial - 23/08/18
, Niels Rochow, MD 1, Lorraine Chessell, RD 1, Jennifer Wilson, MHSc 1, Kathy Cunningham, MHSc 1, Christoph Fusch, MD, PhD 1, 3, Sourabh Dutta, MD, PhD 1, 4, Sumesh Thomas, MD 1, 5Abstract |
Objective |
To evaluate the effect of not relying on prefeeding gastric residual volumes to guide feeding advancement on the time to reach full feeding volumes in preterm infants, compared with routine measurement of gastric residual volumes. We hypothesized that not measuring prefeeding gastric residual volumes can shorten the time to reach full feeds.
Study design |
In this single-center, randomized, controlled trial, we included gavage fed preterm infants with birth weights (BW) 1500-2000 g who were enrolled within 48 hours of birth. Exclusion criteria were major congenital malformations, asphyxia, and BW below the third percentile. In the study group, the gastric residual volume was measured only in the presence of bloody aspirates, vomiting, or an abnormal abdominal examination. In the control group, gastric residual volume was assessed routinely, and feeding advancement was based on the gastric residual volume. The primary outcome was the time to reach feeding volumes of 120 mL/kg per day. Secondary outcomes were time to regain BW, episodes of feeding interruptions, sepsis, and necrotizing enterocolitis.
Results |
Eighty-seven infants were enrolled. There were no differences between the study and control groups with respect to time to reach full feeds (6 days [95% CI, 5.5-6.5] vs 5 days [95% CI, 4.5-5.5]; P = .82), time to regain BW, episodes of feeding interruptions, or sepsis. Two infants in the control group developed necrotizing enterocolitis.
Conclusions |
Avoiding routine assessment of gastric residual volume before feeding advancement did not shorten the time to reach full feeds in preterm infants with BW between 1500 and 2000 g.
Trial registration |
Clinicaltrials.gov: NCT01337622.
Le texte complet de cet article est disponible en PDF.Keywords : feeding intolerance, gastric residual volume, necrotizing enterocolitis, very low birth weight
**Abbreviations : BW, NEC, NICU, VLBW
Plan
| The authors declare no conflicts of interest. |
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| Portions of this study were presented at the 5th Congress of the European Academy of Pediatric Societies, Barcelona, Spain on October, 18th, 2014, the Canadian Neonatal Perinatal Research Meeting, Montebello, Canada on February 26th, 2015, and as a poster presentation at the Pediatric Academic Societies annual meeting, San Diego, CA, on April 27th, 2015. |
Vol 200
P. 79 - septembre 2018 Retour au numéro
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