Gastric residuals

[Ommyar]

Hello every body,,when the gastric aspiration became significant regardless the color.

[Francesco Cardona]

Hi Ommyar,

In this study by Cobb et al. they found that if babies had >40% of their feedings as residuals, risk for NEC was higher. http://pediatrics.aappublications.org/content/113/1/50.abstract

In another paper (I cant find the citation..) the authors found that only residuals that were green/bilous had any impact on the clinical situation of a baby.

[Ommyar]

Thanks

[Dinesh N Patel]

In VLBW Infant and infant with H/O unfavorable fetal Doppler study , we consider more than 50%of previous feed is significant at the next feed and witheld that feed and reassess clinically. If there is no distention of abdomen, we returne the residual back ,And Don't give feed at that time and reassess before next feed. If thete is distended abdoman we discard the aspirate, make NBM for a day or two and reassess,if vitals are stable restart feedings

Dinesh

[selvanr4]

More than 50% of previous feeds, distension abdomen , reducing platelet trend and positive occult blood in stools points out to NEC . Followup as dr.dinesh suggested

[Guest ajaymenon]

There are lots of variables ,while talking about gastric residue. Depending on  antenatal environment  (doppler scan and maternal health /illness, medications ) how often the child is  feed ( 1 hrly 2 hrly or more), tropic feeds, initiated and tolerated or not, gestation of the baby , underlying condition and interventions and medications  given ( cpap,caffeine ,antibiotics, ),type of feed (breast or bottle).

As mentioned before ,if the child is clinically well, with no abdominal distension  and stable vital parameters ,it doesn't make  sense to aspirate the tummy frequently ,and potentially injury the intestinal mucosa.

Obviously  a sick child with abdominal distension,fluctuating vitals parameters,and dubious blood/stool result is  a different ball game altogether.  

[peppepag]

The true question is when we need to control gastric residual.... I think only when we have vomiting and or abdominal dissension. What do you think about?