Do We Really Need to Check Gastric Residuals? Probably Not.

In most hospitals, gastric residuals are monitored for all patients who receive enteral feeding. The theory is that patients with larger residuals will be at greater risk for vomiting, subsequent aspiration, and ventilator-associated pneumonia (VAP). The downside of this monitoring is that tube feeds often are withheld when residuals are large, which results in inadequate nutrition.

French investigators randomized 449 mechanically ventilated patients to either routine gastric residual monitoring or no monitoring. For patients in the monitored group, gastric residuals were measured every 6 hours. Residual volume >250 mL in the monitored group, or vomiting in both groups, was considered a sign of intolerance and triggered treatment with a prok…