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American Journal of Critical Care. 2009;18: 10 doi:10.4037/ajcc2009822
Copyright © 2009 by the American Association of Critical-Care Nurses.
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LETTERS

Response

By Norma Metheny, RN, PhD. St Louis, Missouri

My colleagues and I appreciate the thoughtful letter from Mr Stambovsky about the best technique for measuring residual volume. All too often, nurses make a single quick attempt to aspirate fluid from a feeding tube and then quit, assuming no fluid is present. However, as the reader wisely observes, it usually takes time and patience to accurately measure residual volumes. As indicated in our article,1 we forced 30 mL of air through the tube with a 60-mL syringe prior to each aspiration attempt in order to force the tube’s ports away from the mucosal folds. However, we failed to indicate that we repeated this process 2 to 3 times during each measurement attempt. It often took us several minutes to complete each measurement.

As the reader suggests, slow and gentle withdrawal of the plunger after each air insufflation works best. Although it takes time and patience to measure residual volumes, it is certainly time well spent when it helps identify a patient who is not tolerating feedings.

doi: 10.4037/ajcc2009822

FINANCIAL DISCLOSURES
None reported.

REFERENCE

  1. Metheny NA, Schallom L, Oliver DA, Clouse RE. Gastric residual volume and aspiration in critically ill patients receiving gastric feedings. Am J Crit Care. 2008;17(6):512–520.[Abstract/Free Full Text]




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