Prematurity Clinical Trial
Official title:
A Prospective, Randomized and Controlled Trial Comparing the Role of no Gastric Residual ASSessment and Standard Gastric Residual Measurement for the Achievement of Full Enteral Feeding in Preterm Infants
The study aims to compare routine assessment of gastric residuals versus no assessment of residuals in preterm neonates with respect to time taken for achieving full enteral feeding and the incidence of possible complications, such as feeding intolerance, necrotizing enterocolitis, sepsis etc.
In general, regular assessment of gastric residuals and its´ evaluation prior to every
feeding is considered standard practice for preterm neonates in neonatal intensive care
units. It is believed useful to confirm correct placement of the orogastric or nasogastric
tube and thought of as necessary to aid the decision of enteral feeding advancement by
informing about possible remains of contents from previous feeding. Furthermore, evaluation
of gastric residuals is routinely performed in order to assess for feeding intolerance and
used as a possible indicator of risk for development of necrotizing enterocolitis.
However there is conflicting evidence to support the approach of routine gastric residuals
assessment and it seems unclear whether it confers any clinical benefit. Withholding of
enteral feeding or cessation of advancement in the amounts given due to misinterpretation of
routine gastric aspirates may have a negative impact on the preterm neonate. This can
potentially involve prolonged indwelling of venous catheters, higher risk of infection and
growth restriction with potentially worse developmental outcome in particular for very low
birth weight infants.
This randomized controlled clinical study aims to compare a control group with regular
assessment and evaluation of gastric residuals and an intervention group with no routine
assessment of residuals prior to feeding advancement, for the time taken to reach full
enteral feeding and for occurrence of any observed complications including necrotizing
enterocolitis.
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