Author Question: You read in the physician's orders that the patient experienced high gastric residual volume (GRV) ... (Read 19 times)

Lobcity · **on:** Aug 21, 2018

You read in the physician's orders that the patient experienced high gastric residual volume (GRV) and the enteral feeding was discontinued. Define high GRV.

Using evidence-based guidelines, what recommendations are given regarding definition of high GRV? What recommendations would you make?

Question 2

Are there any known health benefits of following a gluten-free diet if a person does not have celiac disease?

What will be an ideal response?

komodo7 · **Reply #1 on:** Aug 21, 2018

Answer to Question 1

As part of most gastric enteral feeding protocols, gastric residuals are aspirated periodically to ensure appropriate gastric emptying and decrease risk of aspiration of gastric contents.
There is some disagreement regarding efficacy of this practice. This is because it is difficult to distinguish the enteral feeding formula from other gastric secretions when residuals are taken. In most stable, long-term patients this practice is not necessary.
High gastric residual volume is often defined as 500 mL, although there is no definitive definition.
In critically ill patients such as Mr. H, gastric residuals should be checked every four hours.
Additionally, if > 250 mL is present after two GRV checks, a promotility agent should be considered.
Probable causes for Mr. Hayato's high GRV are gastroparesis and/or position.

Answer to Question 2

No, adherence to a gluten-free dietary pattern may result in a diet low in:
Carbohydrates
Iron
Folate
Niacin
Zinc
Fiber
B12
Calcium
Phosphorus