Safe monitoring of GRV

[kalm...@gmail.com]

Hi

I am a Norwegian ICU nurse, working in a mixed ICU for medical and
surgical patients. Most of our patients are intubated and sedated for
most of the stay. When the patient stabilizes he or she is transferred
to another hospital.

After piloting the PEPUp study, our ICU nurses wishes to increase the
GRV limit to above 200ml. Due to problems safely aspirating the
gastric content on the smaller feeding tubes, we are currently having
a discussion on weather to use smaller feeding tubes or sump tubes.
Our experience is that the feeding tubes collapses, and do not give
the "whole" picture on the GRV status. We have had a few cases now
where we due to uncertainty concerning GRV and feeding tubes, also had
to insert a sump tube, this resulting in larger quantities of aspirate
than on the feeding tube alone.

Do any of you have good guidelines or experiences, comments on what
kind of tube to use and for how long?

Yours sincerely

Kristin Alm-Kruse

[trac...@rcht.cornwall.nhs.uk]

We currently use a larger size 12 feeding tube which appears to deal
with all the problem you have described. we use GRV 250 and have no
problems with drainage or aspirating as is often the case with the
smaller feeding tubes.