The Significance of Gastric Residuals in the Early Enteral Feeding Advancement of Extremely Low Birth Weight Infants

Objective. To evaluate whether the mean gastric residual volume (GRV) and green gastric residuals (GR) themselves are significant predictors of feeding intolerance in the early enteral feeding advance- ment in extremely low birth weight (ELBW; 750 g was tolerated. In cases of increased GRV, feedings were re- duced or withheld. The color of GR was assessed as clear, milky, green-clear, green-cloudy, blood-stained, or hem- orrhagic. Multiple regression analysis was used to study the effect of the mean GRV and the color of GR on the feeding volume on day 14 (V14). Results. The median V14 was 103 mL/kg/d (0 -166). V14 increased with an increasing percentage of milky GR, whereas the mean GRV and the color green did not have a significant effect. Conclusions. 1) Early enteral feeding could be estab- lished in ELBW infants. The critical GRV seems to be above 2 mL/3 mL because there was no significant neg- ative correlation between the mean GRV and V14. 2) Green GR were not negatively correlated with V14 and should not slow down the advancement of feeding vol- umes in absence of other clinical signs and symptoms. Pediatrics 2002;109:457- 459; infant nutrition, extremely low birth weight infant, gastric residual.