Current status of enteral nutrition tolerance and gastric residual volume monitoring in elderly critically ill patients in ICU

Abstract

Objective To investigate the current status of monitoring gastric residual volume (GRV) and enteral nutrition (EN) tolerance in critically ill elderly patients in ICU nationwide, so as to provide evidence for finding the best assessment method of EN tolerance in critically ill elderly patients and standardizing the operation procedure. Methods A total of 724 ICU critically ill elderly patients from 22 provinces, 5 autonomous regions and 4 municipalities were selected by convenience sampling method and investigated for EN strategy management, EN pipeline maintenance, EN tolerance assessment and GRV monitoring. Results During the period of enteral nutrition in critically ill elderly patients, 461 (63.7%) of the 724 ICUs surveyed performed routine GRV monitoring, 166 (22.9%) used the EN tolerance scoring too, 156 (21.5%) used ultrasound to monitor gastric residual volume. There was no statistical difference in use of EN tolerance score tool and B-mode ultrasound monitoring among different types of ICU (P>0.05) . The incidence of vomiting and dominant aspiration in routine monitoring departments was lower than that in unconventional monitoring departments, and the difference was statistically significant (P<0.05) . Conclusions The elderly critically ill patients should be evaluated EN tolerance every day during the implementation of EN, and routine and feasible GRV monitoring should be carried out. Key words: Aged; Intensive Care Units; Tolerance of enteral nutrition; Gastric residual volume