Parker Leslie, Torrazza Roberto Murgas, Li Yuefeng, Talaga Elizabeth, Shuster Jonathan, Neu Josef
College of Nursing, University of Florida, Box 100187, Gainesville 32610, USA.
J Perinat Neonatal Nurs. 2015 Jan-Mar;29(1):51-9; quiz E2. doi: 10.1097/JPN.0000000000000080.
The routine aspiration of gastric residuals (GR) is considered standard care for critically ill infants in the neonatal intensive care unit (NICU). Unfortunately, scant information exists regarding the risks and benefits associated with this common procedure. This article provides the state of the science regarding what is known about the routine aspiration and evaluation of GRs in the NICU focusing on the following issues: (1) the use of GRs for verification of feeding tube placement, (2) GRs as an indicator of gastric contents, (3) GRs as an indicator of feeding intolerance or necrotizing enterocolitis, (4) the association between GR volume and ventilator-associated pneumonia, (5) whether GRs should be discarded or refed, (6) the definition of an abnormal GR, and (7) the potential risks associated with aspiration and evaluation of GRs. Recommendations for further research and practice guidelines are also provided.
在新生儿重症监护病房（NICU），常规抽吸胃残余物（GR）被视为对危重症婴儿的标准护理措施。遗憾的是，关于这一常见操作的风险和益处，现有信息极少。本文阐述了关于NICU中GR常规抽吸及评估的科学现状，重点关注以下问题：（1）利用GR验证饲管位置；（2）GR作为胃内容物的指标；（3）GR作为喂养不耐受或坏死性小肠结肠炎的指标；（4）GR量与呼吸机相关性肺炎之间的关联；（5）GR应丢弃还是重新喂食；（6）异常GR的定义；（7）GR抽吸及评估的潜在风险。此外，还提供了进一步研究的建议和实践指南。
