A 55-year-old man on ICU has acute pancreatitis. The dietitian recommends early enteral nutrition. However, the patient has a gastric residual volume ...

Question

A 55-year-old man on ICU has acute pancreatitis. The dietitian recommends early enteral nutrition. However, the patient has a gastric residual volume (GRV) of 350 mL. Should enteral feeding be withheld?

Accepted Answer

No - current evidence (including the NUTRIREA-2 trial and ESPEN guidelines) suggests that a single GRV of 300-500 mL should NOT routinely lead to withholding enteral nutrition; GRV monitoring is a poor indicator of aspiration risk and may lead to unnecessary underfeeding; prokinetics should be used and GRV thresholds should be >=500 mL before considering withholding feeds

Answer

Yes - always stop feeding if GRV >200 mL

Answer

Switch to parenteral nutrition immediately

Answer

Insert a PEG tube

Answer

GRV monitoring is mandatory every hour

uk-fficm MCQ (SBA): GRV and Enteral Feed Tolerance

A 55-year-old man on ICU has acute pancreatitis. The dietitian recommends early enteral nutrition. However, the patient has a gastric residual volume (GRV) of 350 mL. Should enteral feeding be withheld?