None listed
Conditions
Brief summary
No studies have been conducted to assess the most appropriate time interval for aspirating gastric tubes. We compared gastric tube aspirations every four hours (usual care) to a variable regimen (up to every eight hours aspirations). This randomized controlled trial (RCT) enrolled patients who stayed in ICU > 48 hours, had a gastric tube, and were likely to receive EN for 3+ days. Patients were randomized (computer-generated randomization) to either control (every four hours) or intervention group (variable regimen). The primary outcome was number of gastric tube aspirations per day from randomization until EN was ceased or up to two weeks post-randomization. Following Institutional Ethics Committee approval, 357 patients were recruited (control group n=179 and intervention group n=178). No differences were found in age, sex, worst APACHE II score or time to start of EN. In the intention to treat analysis, the intervention group had fewer tube aspirations per day (3.4 versus 5.4 in the control group, p<0.001). Vomiting/regurgitation was increased in the intervention group (2.1% versus 3.6%, p=0.02). There were no other differences in complications. This is the first RCT to examine the frequency of gastric tube aspirations. The frequency of gastric tube aspirations was reduced in the variable regimen group with no increase in risk to the patient. Reducing frequency of aspirations saves nursing time, decreases risk of contamination of feeding circuit and minimises risk of body fluid exposure.
Interventions
Variable regimen of gastric tube aspiration. The frequency of gastric tube aspiration in the intervention group will be changed from 4-hourly to 8-hourly once enteral feeding has been established, up to 14 days in ICU or until discharge from ICU, whichever occurs first . If gastric residual volumes are greater than the feed volume administered for the previous 2 hours, 4-hourly gastric tube aspirations will be resumed. If feeding is stopped and resumed at a lower rate than prior to being stopped
Variable regimen of gastric tube aspiration. The frequency of gastric tube aspiration in the intervention group will be changed from 4-hourly to 8-hourly once enteral feeding has been established, up to 14 days in ICU or until discharge from ICU, whichever occurs first . If gastric residual volumes are greater than the feed volume administered for the previous 2 hours, 4-hourly gastric tube aspirations will be resumed. If feeding is stopped and resumed at a lower rate than prior to being stopped, the frequency of gastric tube aspirations will revert back to 4-hourly until the feeding target is achieved. All other treatments in the ICU will follow the usual ICU practices for both groups.
Sponsors
Royal Perth Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
16 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
Patients admitted to the ICU, who stay in the ICU longer than 48 hours, have a gastric tube inserted, and are likely to receive enteral feeding for three or more days
Exclusion criteria
Patients who are unlikely to receive enteral feeding for at least 3 days
Outcome results
None listed