a comparison of two different gastric residual volume following protocol in the enteral nutrition applied to intensive care unit patients

It is known that the feeding methods applied are as important as medical theraphies for the patients observed in intensive care units (ICU). Provided that there are no contraindications to use it, the use of enteral feeding, which is a physiological way, is primarly recommended. The most appropriate gastric residual volume (GRV) threshold and the following interval have not yet been described in the planning and applying of the enteral nutrition. In this clinical study, two different enteral nutrition protocols of enteral nutrition applied ICU patients whose GRV thresholds and checking freqencies were different from each other have been compared.Following the approval of the Dokuz Eylül University Medicine Faculty Clinical and Laborotory Research Ethics Committee, sixty mechanically ventilated patients in the ICU were sequentially divided into two different group.Group I:Patient whose GRV threshold was 100mL and checking frequency was 4 hoursGroup II:Patient whose GRV threshold was 200mL and checking frequency was 8 hoursIn our study, we have observed emesis in 3.3% and diarrhea in 6.6% of Group I, while in Group II, the percentage of emesis was 16.6% and that of diarrhea was 10% . The ratio of the observed total intolerance (emesis and/or diarrhea) episodes were 10% in Group I and 33.3% in Group II. There was a significant difference between the two groups with regards to total number of the gastrointestinal intolerance observations (p=0.02).In accordance with the results of our study, the protocol which has a GRV threshold 100mL / checking frequency of 4 hours (Group I) which has exhibited a lower rate of gastrointetinal intolerance rather than the protocol which has a GRV threshold 200mL / checking frequency of 8 hours (Group II) may be recommendedThe results of this study support the adoption of the proposed feeding protocol for critically ill patients over the current protocol .Key Words: Enteral nutrition, gastric residuel volume, intolerance, ICU