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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.
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.
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 …
Contributors CLB wrote the picket paper; this was edited and revised by CMH.
Provenance and peer review Not commissioned; internally peer reviewed.