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Table 1 The characteristics of included studies

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.