![]() One of the practices that contributes to children not receiving adequate enteral nutrition is the routine measurement of the gastric residual volume (GRV) (fluid in the stomach) to guide both the initiation and progression of enteral feeds. In preterm infants, feeds are gradually increased to the immature, naïve gut and clinicians closely observe feed tolerance and for signs of complications such as necrotising enterocolitis. On average, children in paediatric intensive care units (PICUs) receive less than half of their nutritional requirements. Nutrition should, if at all possible, be delivered enterally to maintain gut barrier function. Potential concerns and preferences were identified that will need careful consideration to inform the development of the proposed trial protocol and staff training.Ĭritically ill neonates and children who receive sufficient nutrition have reduced complications, spend less time on mechanical ventilation, reduced time in intensive care and have overall improved health outcomes. The majority of parents and practitioners viewed the proposed trial as acceptable. Parent’s views on GRV measurement and consent decision making were influenced by their views on the importance of feeding in the ICU, their child’s prognosis and associated comorbidities or complications. However, both groups held concerns about the potential risk of not measuring GRV, including delayed diagnosis of infection and gut problems, increased risk of vomiting into lungs and causing discomfort or pain. Participants described how the research question was logical, and the intervention would not be invasive and potential benefits of not withholding the child’s feeds. We interviewed 31 parents and nine practitioners and ran five practitioner focus groups ( n=42). Data were analysed using thematic analysis and descriptive statistics. A voting system recorded closed question responses during practitioner data collection, enabling the collection of quantitative and qualitative data. MethodsĪ mixed-methods study involving interviews and focus groups with practitioners and interviews with parents with experience of tube feeding in neonatal and/or paediatric intensive care. As part of a feasibility study, we explored parent and practitioner views on the acceptability of a trial comparing GRV measurement or no GRV measurement. However, this practice is not evidence based and may cause harm. Routine measurement of gastric residual volume (GRV) to guide feeding in neonatal and paediatric intensive care is widespread.
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