Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 29 May 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Gastric volume monitoring in ventilated patients receiving enteral feeding

A study in this week's issue of the Journal of the American Medical Association examines the effect of not monitoring residual gastric volume on risk of ventilator-associated pneumonia in adults receiving mechanical ventilation and early enteral feeding.

News image

Monitoring of residual gastric volume is recommended to prevent ventilator-associated pneumonia (VAP) in patients receiving early enteral nutrition.

However, studies have challenged the reliability and effectiveness of this measure.

Dr Jean Reignier and colleagues examined wether the risk of VAP is increased when residual gastric volume is not monitored compared with routine residual gastric volume monitoring in patients receiving invasive mechanical ventilation and early enteral nutrition.

The team performed a randomized, noninferiority, open-label, multicenter trial conducted from 2010 through 2011 in adults requiring invasive mechanical ventilation for more than 2 days and given enteral nutrition within 36 hours after intubation at 9 French intensive care units (ICUs).

The team randomized 452 patients, and 449 included in the intention-to-treat analysis.

The prestated noninferiority margin was 10%
Journal of the American Medical Association

Intolerance to enteral nutrition was based only on regurgitation and vomiting in the intervention group, and based on residual gastric volume greater than 250 mL at any of the 6 hourly measurements and regurgitation or vomiting in the control group.

The team's main outcome measures included the proportion of patients with at least 1 VAP episode within 90 days after randomization, as assessed by an adjudication committee blinded to patient group.

The team observed that the prestated noninferiority margin was 10%.

The doctors observed that results in the intention-to-treat population, VAP occurred in 38 of 227 patients in the intervention group, and in 35 of 222 patients in the control group.

There were no significant between-group differences in other ICU-acquired infections, mechanical ventilation duration, ICU stay length, or mortality rates.

The team found that the proportion of patients receiving 100% of their calorie goal was higher in the intervention group.

The research team obtained similar results in the per-protocol population.

Dr Reignier's team concluded, "Among adults requiring mechanical ventilation and receiving early enteral nutrition, the absence of gastric volume monitoring was not inferior to routine residual gastric volume monitoring in terms of development of VAP."

JAMA 2013; 309(3): 249-256
17 January 2013

Go to top of page Email this page Email this page to a colleague

 27 May 2016 
Obstructive sleep apnea and NASH
 27 May 2016 
Risk stratification in acute upper GI bleeding
 27 May 2016 
Hepatocellular carcinoma in chronic Hep B patients
 26 May 2016 
Education booklet for colonoscopy bowel preparation
 26 May 2016 
Uncomplicated diverticulitis in outpatients
 26 May 2016 
Direct-acting antivirals in Hep C cirrhosis
 25 May 2016 
Preventing NSAID-associated GI toxicity
 25 May 2016 
Recurrence of Barrett’s after successful endoscopic therapy
 25 May 2016 
PPIs and NSAID-induced small bowel injury
 24 May 2016 
Fecal inflammatory markers in Crohn's
 24 May 2016 
Depression and IBD recurrence
 24 May 2016 
New therapies for NASH
 23 May 2016 
Risk factors for peptic ulcer bleeding outcomes
 23 May 2016 
Liver transplantation for hepatocellular carcinoma
 23 May 2016 
Cancer after colectomy in IBD
 20 May 2016 
Biomarker for colorectal cancer diagnosis
 20 May 2016 
Prognostic score for hepatic venous outflow obstruction
 20 May 2016 
Treatment for uncomplicated acute diverticulitis
 19 May 2016 
Probiotics and H. pylori eradication
 19 May 2016 
Impaired skeletal health in atrophic gastritis
 19 May 2016 
Predicting outcome in ulcerative colitis
 18 May 2016 
Erectile dysfunction in IBD
 18 May 2016 
Acute GERD and esophageal histologic changes
 18 May 2016 
Surgical fundoplication for GERD 
 17 May 2016 
Mucosal dysbiosis in Crohn's disease
 17 May 2016 
Vitamin D level and clinical status in IBD 
 17 May 2016 
Inpatient costs for IBD and acute pancreatitis
 16 May 2016 
Outcomes of postcolonoscopy colorectal cancers
 16 May 2016 
Therapy for Crohn's in a Medicaid population
 16 May 2016 
C. difficile in ulcerative colitis patients
 13 May 2016 
Parkinson's disease and IBD
 13 May 2016 
Inactivated oral cholera vaccine
 13 May 2016 
Non-traditional heart disease risk factors in NAFLD
 12 May 2016 
Gestational diabetes mellitus and NAFLD
 12 May 2016 
Impact of Crohn's in the USA
 12 May 2016 
Ozanimod induction and ulcerative colitis
 11 May 2016 
Anti-TNF discontinuation in IBD
 11 May 2016 
Prognosis after colorectal cancer resection
 11 May 2016 
Age and disease presentation with Crohn's disease
 10 May 2016 
Noninvasive test for IBD
 10 May 2016 
Gluten-free diet in patients with IBS-diarrhea
 10 May 2016 
Digital health for gastroenterology
 09 May 2016 
Diarrheal infections in adults
 09 May 2016 
Quality improvement initiative and readmission for cirrhosis
 09 May 2016 
Coffee or tea and the risk of Barrett's
 06 May 2016 
Risk factors in peptic ulcer bleeding
 06 May 2016 
Recurrent pancreatitis after acute pancreatitis
 06 May 2016 
Managing acute lower GI bleeding
 05 May 2016 
Chemoradiotherapy vs chemotherapy for pancreatic cancer
 05 May 2016 
Genetics in early-early-onset IBD
 05 May 2016 
Reductions in quality of screening colonoscopies
 04 May 2016 
Anti-TNF therapy for IBD
 04 May 2016 
Bismuth and H. pylori eradication
 04 May 2016 
Chromoendoscopy vs colonoscopy for dysplasia in colitis
 03 May 2016 
Vedolizumab for IBD
 03 May 2016 
Surgery vs medical therapy for GERD
 03 May 2016 
PPIs and gut microbiota
 02 May 2016 
Genetic variant that increase NAFLD risk
 02 May 2016 
Resection of colorectal polyps
 02 May 2016 
Mycophenolate mofetil as first-line treatment of autoimmune hepatitis

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us