P061 - EVALUATING A 200 ML GASTRIC RESIDUAL VOLUME THRESHOLD IN ICU PATIENTS RECEIVING ENTERAL NUTRITION: A RETROSPECTIVE STUDY

P061

EVALUATING A 200 ML GASTRIC RESIDUAL VOLUME THRESHOLD IN ICU PATIENTS RECEIVING ENTERAL NUTRITION: A RETROSPECTIVE STUDY

J. G. Lee^1,*, J. Y. Jeong², S. M. Baik¹, S. J. Park³, Y. Y. Shin³

¹Surgery, ²Nutrition, ³Internal medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea, Republic Of

Rationale: Gastric residual volume (GRV) monitoring is a common yet controversial practice in intensive care units (ICUs). Despite international guidelines advising against routine GRV checks and recommending higher thresholds (e.g., 500 mL),  our center stopped EN historically at GRV ≥50 mL. This study aimed to assess the safety and clinical outcomes of raising the GRV threshold to 200 mL in critically ill patients.

Methods: We retrospectively reviewed ICU patients receiving enteral nutrition between April and June 2024. GRV was measured before each feeding (intermittent EN) or once daily (continuous EN). Clinical data including demographics, APACHE II scores, ICU/hospital length of stay (LOS), sedative/vasopressor/prokinetic use, and GI intolerance (vomiting, nausea, distension, discomfort, aspiration, pneumonia) were collected. GRV ≥200 mL events were identified and compared with <200 mL events using chi-square or Fisher’s exact test. Clinical outcomes were analyzed using Mann-Whitney U or t-tests.

Results: A total of 95 ICU patients (mean age 70.4 years; mean APACHE II score 26.96) were included, with 937 GRV measurements analyzed. GRV ≥200 mL occurred in only 12 cases (1.3%), involving 5 patients, and was more frequent during intermittent feeding (11 cases) than continuous feeding (1 case) (p = 0.042). There were no EN-related GI complications or adverse clinical outcomes associated with GRV ≥200 mL. No significant associations were found with the use of sedatives (p = 0.447), vasopressors (p = 0.560), or prokinetics (p = 0.486). Continuous feeding resulted in higher EN delivery (941.3 ± 434.1 mL vs. 685.9 ± 411.3 mL, p < 0.001) and lower maximum GRV (3.2 ± 15.3 mL vs. 14.9 ± 39.2 mL, p < 0.001) compared to intermittent feeding.

Conclusion: Raising the GRV threshold from 50 mL to 200 mL did not increase gastrointestinal intolerance or adverse clinical outcomes in ICU patients. 

Disclosure of Interest: None declared