The 1st Razavi Congress in Clinical Nutrition in conjunction with The 2nd International Symposium on
President of INA, Luciana Sutanto, MD gaves lecture about Gastric Residue in ICU Patients.
The abstract: Physiologically, gaster is never empty, there is always residue in the gaster ranges from 0 to 100 mL. In some situations, gastric residue can increase above normal, it is very often found in ICU’s patients. High gastric residue is risky for pulmonary aspiration, it is often proved fatal to patients. To prevent pulmonary aspiration from the effect of high gastric residue is by elevating patients’ head at 45 degrees. Experts gave ‘cut off’ of high gastric residual volume in different numbers, those are 250 mL, 400 mL, 500 mL or higher.
Generally, gastric residual volume is caused by the density and volume of the food, the rate of the enteral feeding administration, the feeding schedule, and the position of patients. All of those factors can cause different volume of gastric residue.
In ICU, the primary factors that contribute to high gastric residue are unstable hemodynamic, hypokalemia, and hyperglycaemia, that cause pyloric stenosis and dismotility. In order to prevent high gastric residue, serum potassium level should be maintained 4 mEq/L or above, blood glucose 180 mg/dL or less, and hemodynamic stable.
In conclusion, to interpret the volume of the gastric residue, we should consider all of the above factors.