From: Is discard better than return gastric residual aspirates: a systematic review and meta-analysis
Study (author year) | Country | Sample (discard /return) | Population | Intervention | Outcomes | Conclusions | |
---|---|---|---|---|---|---|---|
Discard group | Return group | ||||||
Behairy 2014 [19] | Egypt | 44 (20/24) | Adult patients connected with EN within first 24 h and for 7 consecutive days | Discarded all gastric aspirate before feeding, | Returned the gastric aspirate up to 250 ml | The GRV, gastric emptying delay, the aspiration pneumonia, feeding intolerance (vomiting & diarrhea), the electrolytes & glucose level, comfort outcomes (vital signs and oxygen saturation) on 1st and 7th day. | It is recommended to return gastric aspirate up to 250 ml to the patients. |
Booker 2000 [18] | USA | 18 (10/8) | Critically ill adult ICUs patients with expected EN > 48 h. | Discarded all the residual volumes before feeding | Had all the residuals returned through the feeding tube. | Weight changes; serum level of electrolytes; complications such as diarrhea, nausea, vomiting et al. | It’s tempting to encourage nurses to discard the residual volumes. |
Juvé-Udina 2009 [17] | Spain | 122 (61/61) | Critically ill ICU adult patient with estimated length of stay > 48 h | Any aspirate was discarded. | Returned the gastric aspirate up to 250 ml | Nasal gastric tube obstructive complication episodes; pulmonary aspiration episodes; intolerance episodes (nausea, vomiting, diarrhoea and abdominal distension); enteral feeding delays; hyperkalaemia, hyperglycaemia episodes; discomfort episodes | Re-introduce gastric content aspirated to improve GRV management is favored |
Wang 2017 [20] | China | 130 (65/65) | Surgical ICU adult patients with total or part EN | All the aspirates were discarded. | Returned the gastric aspirate up to 150 ml | The incidence of gastric emptying delay; the serum level of blood sugar, potassium, blood sodium; related complications (the incidence of gastric retention, tube blockage, diarrhea and aspiration) | Re-transfusion of gastric retention fluid is recommened. |