Gastric Residual Volume Assessment in Critically Ill Children: The GASTRIC-PICU Randomized Clinical Trial.
Lyvonne N Tume, Paul R Mouncey, Julia M Broomhall et al.
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In 30 seconds
The GASTRIC-PICU trial evaluated the impact of routine gastric residual volume (GRV) assessment on enteral feeding in critically ill children. In a multicenter, randomized controlled trial involving 4700 children on mechanical ventilation, the study found that not routinely assessing GRV was noninferior to regular assessments for survival and days free from mechanical ventilation at 30 days, while achieving a higher percentage of energy requirements by 72 hours (80.3% vs 76.8%).
Key findings
- No routine GRV assessment was noninferior to regular assessments for survival and days free from mechanical ventilation at 30 days.
- Median days free from mechanical ventilation was 25 days in both groups.
- The mean percentage of energy requirements achieved by 72 hours was 80.3% in the no routine GRV assessment group.
- The adjusted mean difference in energy achievement was 3.2 percentage points, P < .001.
Why it matters
This study challenges the routine practice of GRV assessment in critically ill children, suggesting that it may not be necessary and could hinder nutritional delivery. Improved nutritional outcomes can enhance recovery in this vulnerable population.