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Not measuring residual gastric volumes in preterm infants can increase the progression of enteral nutrition with earlier discharge from hospital
  1. Catherine M Harrison,
  2. Claire Louise Blythe
  1. Neonatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  1. Correspondence to Dr Catherine M Harrison, Neonatology, Leeds Teaching Hospitals NHS Trust, Leeds LS1 3EX, UK; catherine.harrison10{at}

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Review of: Parker LA, Weaver M, Murgas Torrazza, et al. Effect of gastric residual evaluation on enteral intake in extremely preterm infants a randomised clinical trial. JAMA Pediatrics 2019;173:534–43.

Study design

Design: Single centre randomised clinical trial.

Allocation: Low risk of randomisation bias, used computer generated sequencing. Unclear risk of allocation concealment bias, not clearly described.

Blinding: Not blinded.

Study question

Setting: Level 4 neonatal unit (regional neonatal intensive care unit), USA.

Patients: Infants born at ≤32 weeks’ gestation and ≤1250 g due to be fed human milk. Babies with congenital anomalies, chromosome abnormalities or a gastro-intestinal condition were excluded. Participation stopped if stage II or greater necrotising enterocolitis (NEC) or spontaneous intestinal perforation diagnosed.

Intervention: Residuals group (74 infants) underwent prefeed gastric residual measurement and this was factored in clinical decisions using the NICU nutritional guidelines.

Comparison: No measurement of residuals (69 infants). Feeds stopped if episode of emesis or increased abdominal circumference >2 cm. Gastric content aspiration not used to verify tube placement.

Outcomes: Primary: weekly enteral intake in ml/kg for …

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  • Contributors CLB wrote the picket paper; this was edited and revised by CMH.

  • Provenance and peer review Not commissioned; internally peer reviewed.