PD242 - APPLYING GASTRIC RESIDUAL VOLUME AS ONE OF THE INDICATORS FOR ENTERAL FEEDING INTOLERANCE: A SCOPING REVIEW

PD242

APPLYING GASTRIC RESIDUAL VOLUME AS ONE OF THE INDICATORS FOR ENTERAL FEEDING INTOLERANCE: A SCOPING REVIEW

A. T. Bui^1,2,*, A. K. Dang³, T. Q. T. Tran⁴

¹Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University, Okayama, Japan, ²Thanh Hoa Campus, Hanoi Medical University, Thanh Hoa, ³Department of Nutrition and Food Safety, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi Medical University, Hanoi, ⁴Bai Chay Hospital, Quang Ninh, Viet Nam

Rationale: Measuring gastric residual volume (GRV) remains common in intensive care units (ICUs), despite inconsistent evidence linking it to enteral feeding intolerance (EFI) or ventilator-associated pneumonia. Thresholds defining high GRV vary widely, depending on various clinical practices in different countries. This scoping review aimed to: (1) identify GRV thresholds indicating feeding intolerance in adult ICU patients; and (2) describe GRV-related management practices.

Methods: This review was conducted following the Population–Concept–Context (PCC) framework. A comprehensive search was performed in PubMed and Web of Science, extracting studies published from 2010 to 2024. Studies were eligible if they were original research, trials, pre- and post-intervention studies, and case reports/case series, and reported both GRV threshold and specific management strategies. We excluded articles that were any type of reviews, or studies that did not use GRV for measuring EFI, or provided insufficient data regarding the GRV thresholds and their management.

Results: Among 73 records for screening, 25 studies were eligible. GRV monitoring was typically performed every 4 - 6 hours. Most studies used 200–250mL as the most frequently used reference point. Some other studies combined GRV and clinical symptoms - such as nausea, vomiting, or distension - to determine intolerance. If GRV exceeded thresholds, gradual steps would be performed by reducing feeding rate, prokinetic administration, or even transitioning to post-pyloric nutrition and EN suspension in case GRV was above the upper threshold or other signs of EFI existed in parallel. 

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Conclusion: Most studies used 200–250 ml as a cautious GRV threshold for an early recognition of feeding intolerance. Management of high GRV for lower thresholds tended to be less absolute, while stricter management was performed if GRV exceeded the upper GRV threshold.

Disclosure of Interest: None declared