The Effects Of Monitoring Gastric Residual Volume On Critically Ill Patients Receiving Enteral Nutrition:A Meta-Analysis

Background: In recent years,the clinicians pay more attention to nutritional support treatment of critically ill patients.Enteral nutrition(EN)is the preferred way,but patients often occur complications(vomiting,aspiration,and aspiration pneumonia and so on)due to intolerance,then lead to the condition aggravation.Monitoring gastric residual volume(GRV)has been a method to assess EN tolerance.However,there is a lack of accepted and standard monitoring GRV method,and there are many factors affecting it,the accuracy of the result is questioned,and whether monitoring GRV can reduce the incidence of EN complications is controversial.Objective: The purpose of our study about the effects of monitoring GRV on critically ill patients receiving EN,is to provide information for clinical diagnosis and treatment.Methods: According to search terms,the PubMed,EMBASE,Web of Science,Cochrance Library,Clinical Trials.gov,CNKI and Wanfang databases were used to search the randomized controlled study,quasi-experimental study or observational study from their establishment to October 2019.Through reading the title,abstract,full text,we included relevant literatures and evaluated the quality,the combination and analysis of data were analyzed by Review Manager.Results: A total of 1816 critically ill patients receiving EN were included in 11 literatures(six English literatures,five Chinese literatures;seven randomized controlled studies,three quasi-experimental studies,one observational study).The results of Meta-analysis showed that monitoring GRV decreased the incidence of vomiting and abdominal distension(P < 0.05),but it was no effects on the incidence of diarrhea and pneumonia,the length of stay in ICU,the mechanical ventilation time,the mortality(P>0.05).It also reduced the nutritional intake.Conclusion: Monitoring GRV in critically ill patients receiving EN has certain clinical significance,but routine monitoring GRV is not recommended.Clinicians should develop and use standardized and individualized EN treatment plans,combining the symptoms,signs and abdominal X ray sheet,so as to assess EN intolerance and ensure adequate nutrition and safe feeding of critically ill patients.