Do we control gastric residuals unnecessarily in premature newborns? AGRA study: avoidance of gastric residual aspiration

• Published in: World journal of pediatric surgery Vol. 3; no. 1; p. e000056
• Main Authors: Akar, Selahattin, Turgut, Mehmet
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 27.01.2020; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Abdomen; Birth weight; Enteral nutrition; Gastrointestinal diseases; Intensive care; Necrosis; neonatology; Newborn babies; Normal distribution; Nutrition; Original Research; Parenteral nutrition; Patients; Physiology; Premature babies; Premature birth; Sepsis; Statistical analysis; Variables; Ventilators; neonatology
• ISSN: 2516-5410; 2096-6938; 2516-5410
• DOI: 10.1136/wjps-2019-000056

Aspiration and evaluation of gastric residuals are commonly performed interventions before each feeding in intensive care units, especially in very low birthweight infants. However, there is no sufficient evidence about the necessity of routine gastric residual aspiration. In this study, we aimed to investigate the time to full enteral intake and the incidence of necrotizing enterocolitis (NEC) in preterm infants in the period with gastric residual aspiration performed before each feeding, and those in the period without gastric residual aspiration.MethodsPreterm infants with a gestational week ≤33 were included in the study. The group with gastric residual control before each feeding consisted of 169 infants, and the group without routine gastric residual aspiration included 122 infants.ResultsThe mean gestational week was 30.37±2.58 and 29.31±3.37 in the group with gastric residual control and in the group without routine residual control, respectively (p<0.05). Birth weight, male gender, and mode of delivery were similar between both groups. The time to full enteral intake was shorter in the group without routine residual control (p<0.05). Total durations of parenteral nutrition, ≥grade 2 NEC, weight at discharge and duration of hospitalization were similar between the groups. Duration of invasive mechanical ventilator support was shorter in the group without routine residual control.ConclusionAvoidance of routine gastric residual aspiration in preterm infants shortens the time to full enteral intake without increasing the incidence of NEC.