Routine Monitoring of Gastric Residuals: Practice and Research Update
Until recently, routine monitoring of gastric residuals has been standard care in most neonatal intensive care units (NICUs). Rationale for this practice includes early recognition of feeding intolerance and necrotizing enterocolitis. However, gastric residuals are often used to direct feeding decisions and thus their use can result in delays and interruptions in feeding resulting in an increased risk of complications. Recent evidence suggests that the routine monitoring of gastric residuals prior to every feeding may not be clinically necessary and other clinical indicators may be sufficient to monitor for feeding intolerance and necrotizing enterocolitis. This presentation will describe practices clinicians are currently using to monitor gastric residuals In addition, an overview of current evidence including the risks and benefits of monitoring gastric residuals, alternatives to monitoring gastric residuals, and how to best change unit practice in order to decrease the routine use of aspirating and evaluating gastric residuals prior to every feeding will be presented.
This presentation was originally offered at our GOLD Neonatal Online Conference 2023.
Leslie Parker has a dual position at the College of Nursing and the College of Medicine at the University of Florida where she is a professor. She has been a neonatal nurse practitioner since 1990 and continues to practice as a neonatal nurse practitioner in the NICU at UF Health. She was the tract coordinator of the neonatal nurse practitioner program from 1992-2011. She has been involved in human milk research for nearly two decades and focuses on improving milk production in mothers of critically ill and premature infants. She is funded by the National Institutes of Health for her team’s work regarding neonatal nutrition including the risk of feeding tube contamination, risks and benefits of gastric residual evaluation and optimizing consumption of breast milk for preterm infants.
1. Describe the most recent research regarding the practice of monitoring gastric residuals
2. Explain the potential risks and benefits of monitoring gastric residuals
3. Describe potential practice changes regarding monitoring gastric residuals
Until recently, routine monitoring of gastric residuals has been standard care in most neonatal intensive care units (NICUs). Rationale for this practice includes early recognition of feeding intolerance and necrotizing enterocolitis. However, gastric residuals are often used to direct feeding decisions and thus their use can result in delays and interruptions in feeding resulting in an increased risk of complications. Recent evidence suggests that the routine monitoring of gastric residuals prior to every feeding may not be clinically necessary and other clinical indicators may be sufficient to monitor for feeding intolerance and necrotizing enterocolitis. This presentation will describe practices clinicians are currently using to monitor gastric residuals In addition, an overview of current evidence including the risks and benefits of monitoring gastric residuals, alternatives to monitoring gastric residuals, and how to best change unit practice in order to decrease the routine use of aspirating and evaluating gastric residuals prior to every feeding will be presented.
Accreditation
CERPs - Continuing Education Recognition Points
Applicable to IBCLC Lactation Consultants, Certified Lactation Consultants (CLCs), CBEs, CLE, Doulas & Birth Educators. GOLD Conferences has been designated as a Long Term Provider of CERPs by IBLCE--Approval #CLT114-07. This program is approved for 1 R-CERP.
CMEs - Continuing Medical Education Credits for Physicians & Nurses
The AAFP has reviewed the activity and deemed it acceptable for AAFP credit. Term of approval is from 05/30/2023 to 05/30/2024. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This activity is approved for 1 AAFP Prescribed CME credit.
Nursing CEUs - Nursing Contact Hours
This nursing continuing professional development activity was approved by the American Nurses Association Massachusetts, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation for 1 Nursing Contact Hours.
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Additional Details
Viewing Time: 2 Weeks
Tags / Categories
(IBCLC) Development and Nutrition, (IBCLC) Pathology, Evidence Based Care in Nicu, Necrotizing Enterocolitis, Neonatal Screening
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