Point-of-care ultrasound estimation of gastric residual volume in preterm infants: development of a calculation model
Year: 2025
Type: article
Study design: Observational Study
Abstract: The aspiration of gastric residual volume through the gastric tube increases the risk of feed interruption episodes, prolongs the time needed to achieve full enteral feeding and regain birth weight, and may potentially damage the gastric mucous. This study aimed to develop a point-of-care ultrasound-based model to calculate gastric residual volume in preterm infants. This observational study enrolled 100 preterm infants who fed by gastric tube. The collected data included general characteristics of the preterm infants, the antral cross-sectional area in the right lateral position within 30 min prior to feeding and the gastric residue volume measured through gastric tube. A linear regression analysis was conducted to assess the relationship between the antral cross-sectional area and the aspirated gastric residual volume, with the calculation of the Pearson correlation coefficient. A stepwise linear multiple regression was employed to model the relationship between the suctioned residual volume and the parameters under consideration. Subsequently, we utilized the Bland-Altman plot to assess the agreement between the gastric residual volume measured by aspiration and our model, respectively. Overall, 89 preterm infants were included in the final analysis. Pearson correlation analysis revealed a significant correlation between the gastric antral cross-sectional area in the right lateral decubitus position and the suctioned volume (P < 0.001; correlation coefficient: 0.905). We developed an ultrasound calculation model as follows: Volume (ml)= -3.74 + 9.08 × Gastric Antral Cross-Sectional Area (measured in the right lateral decubitus position) (cm2). When comparing the ultrasound calculated volume and suctioned volume, the mean was 0.05 ml kg-1 and the limit of consistency was − 1.59 to 1.69 ml kg-1 between the ultrasound calculated volume and suctioned one. The use of ultrasound to assess gastric residual volume (GRV) offers a promising alternative to gastric tube suction, potentially reducing associated complications and enhancing enteral nutrition management in preterm infants. Our study represents a pioneering effort in the development of a point-of-care ultrasound-based calculation model for non-invasive GRV assessment in this vulnerable population. What is already known on this topic 1. Nurses mainly assess the gastric residual volume by aspirating the gastric contents via an gastric tube, which interferes with the rehabilitation process to a certain extent. 2. There is a significant relationship between the antral cross-sectional area and gastric residual volume. 3. Ultrasound examination of the antrum is an easy-to-perform tool that may allow reliable assessment of the gastric residual volume in both adults and children. What this study adds 1. This study demonstrates that the cross-sectional area of the gastric antrum in the right lateral decubitus is a crucial factor for estimating gastric residual volume in preterm infants. 2. This study established a model for calculating gastric residual volume in premature infants using ultrasound. How this study might affect research, practice or policy 1. The findings of this study could potentially impact the assessment of gastric residual volume in preterm infants and facilitate the implementation of intestinal feeding.
Authors: Lulu Cui, Meilin Sun, Cancan Li, Huixia Zhang, Yajuan Lu, Yifan Huang
Institution: First Affiliated Hospital of Zhengzhou University
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,790
OpenAlex ID: W4409525027