Omitting routine gastric residual checks may help to accelerate enteral feeds and postnatal growth in stable preterm infants
Makaleler > Tam Makale · 2021
Yazarlar: Demet TEREK, Mahmut ÇELİK, Firat Ergin, Elif Erol, Özge ALTUN, Mehmet YALAZ, Mete AKISU, Nilgun Kultursay
Journal of Parenteral and Enteral Nutrition, SCI Expanded İndekslerine Giren Dergi, Uluslararası, Wos, 2021, cilt 46, ss 1198-1202
DOI: 10.1002/jpen.2270
Özet
BACKGROUND: The prefeed gastric residual check (GRC) when increasing the amounts of feeds given via orogastric and nasogastric tubes as a precaution for necrotizing enterocolitis (NEC) and intestinal intolerance is a routine procedure. However, it is mostly misleading, and recently, there has been a tendency not to check prefeed residuals. METHODS: We changed our nutrition protocol at the end of 2018 to start minimal enteral feeds (MEFs) and increase feeds without GRCs. We investigated the effects on the incidence of NEC, complications, time to reach full feeds, and growth parameters RESULTS: We compared the results of 60 preterm infants at ≤35 weeks' gestational age (group 1: 2016-2017, cared for with GRC) and 77 preterm infants (group 2: 2019, without routine GRCs). No differences in incidence of NEC and complications were observed. Group 2 started enteral feeds 3 days earlier, reached total feeds 6 days earlier (P < 0.01), and had higher weight (P < 0.01) and head circumference gain (P < 0.01). Extrauterine growth restriction was significantly less for head circumference and also insignificantly less for weight and height. CONCLUSION: We conclude that starting MEFs earlier and omitting routine GRCs in clinically stable preterm infants accelerate enteral feeds and growth parameters.