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American Academy of Pediatrics
Article

The Significance of Gastric Residuals in the Early Enteral Feeding Advancement of Extremely Low Birth Weight Infants

Walter A. Mihatsch, Patrik von Schoenaich, Hubert Fahnenstich, Norma Dehne, Hartmut Ebbecke, Christian Plath, Hans-Burkhardt von Stockhausen, Rainer Muche, Axel Franz and Frank Pohlandt
Pediatrics March 2002, 109 (3) 457-459; DOI: https://doi.org/10.1542/peds.109.3.457
Walter A. Mihatsch
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Patrik von Schoenaich
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Hubert Fahnenstich
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Norma Dehne
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Hartmut Ebbecke
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Christian Plath
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Hans-Burkhardt von Stockhausen
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Rainer Muche
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Axel Franz
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Frank Pohlandt
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Abstract

Objective. To evaluate whether the mean gastric residual volume (GRV) and green gastric residuals (GR) themselves are significant predictors of feeding intolerance in the early enteral feeding advancement in extremely low birth weight (ELBW; <1000 g) infants.

Design. Ninety-nine ELBW infants were fed following a standardized protocol (day 3–14). At 48 hours of age, milk feeding was started (12 mL/kg/d increments, 12 meals per day). GR were checked before each feeding, and a GRV up to 2 mL/3 mL in infants ≤750 g/>750 g was tolerated. In cases of increased GRV, feedings were reduced or withheld. The color of GR was assessed as clear, milky, green-clear, green-cloudy, blood-stained, or hemorrhagic. Multiple regression analysis was used to study the effect of the mean GRV and the color of GR on the feeding volume on day 14 (V14).

Results. The median V14 was 103 mL/kg/d (0–166). V14 increased with an increasing percentage of milky GR, whereas the mean GRV and the color green did not have a significant effect.

Conclusions. 1) Early enteral feeding could be established in ELBW infants. The critical GRV seems to be above 2 mL/3 mL because there was no significant negative correlation between the mean GRV and V14. 2) Green GR were not negatively correlated with V14 and should not slow down the advancement of feeding volumes in absence of other clinical signs and symptoms.

  • infant nutrition
  • extremely low birth weight infant
  • gastric residual
  • Received April 16, 2001.
  • Accepted August 23, 2001.
  • Copyright © 2002 by the American Academy of Pediatrics

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Pediatrics
Vol. 109, Issue 3
1 Mar 2002
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The Significance of Gastric Residuals in the Early Enteral Feeding Advancement of Extremely Low Birth Weight Infants
Walter A. Mihatsch, Patrik von Schoenaich, Hubert Fahnenstich, Norma Dehne, Hartmut Ebbecke, Christian Plath, Hans-Burkhardt von Stockhausen, Rainer Muche, Axel Franz, Frank Pohlandt
Pediatrics Mar 2002, 109 (3) 457-459; DOI: 10.1542/peds.109.3.457

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The Significance of Gastric Residuals in the Early Enteral Feeding Advancement of Extremely Low Birth Weight Infants
Walter A. Mihatsch, Patrik von Schoenaich, Hubert Fahnenstich, Norma Dehne, Hartmut Ebbecke, Christian Plath, Hans-Burkhardt von Stockhausen, Rainer Muche, Axel Franz, Frank Pohlandt
Pediatrics Mar 2002, 109 (3) 457-459; DOI: 10.1542/peds.109.3.457
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