VOLUME 26 ISSUES 1 | 2024

Evaluating the gastric residual volume (grv) monitoring influence on ventilator-associated pneumonia’s (vap) frequency in icu patients undergoing mechanical ventilation

1Dr Qudsia Usman, 2Dr Muhammad Shameel, 3Dr Khansa Azad, 4Dr Faryal Rasheed, 5Dr Muhammad Amin, 6Dr Mohammed Uzair, 7Kashif Lodhi

1CMH Rawalpindi
2Divisional Headquarters Teaching Hospital Mirpur AJK
3Chandka medical college Larkana
4Graduate of AJKMC
5Bolan Medical Complex Hospital, Quetta
6Chandka Medical College
7Department of Agricultural, Food and Environmental Sciences. Università Politécnica delle Marche Via Brecce Bianche 10, 60131 Ancona (AN) Italy

Abstract
Objective: In recent years, there has been considerable debate over the value of assessing the gastric residual volume (GRV), or the quantity of food still in the stomach, for patients with ventilator-associated pneumonia (VAP). A study on critically sick patients receiving mechanical ventilation was done to find out whether GRV has any effect on the incidence of VAP.
Methods: The critical care unit at Mayo Hospital received 150 adult patients from December 2022 to December  2023. This descriptive research was conducted on these patients. Gastric intolerance was determined by GRV readings greater than 250 ml, which were taken every three hours. The mortality rate, GRV, VAP, stay on mechanical ventilation, stay in the intensive care unit, SOFA and APACHE II scores, and frequency of vomiting were also noted.
Results: According to the quantity of gastric residual volume (GRV) that the patients produced—one group generating more than 250ml and the other producing less than or equal to 250ml—patients were split into two groups for the research. Longer hospitalizations in the intensive care unit (ICU), more frequent use of mechanical ventilation, and higher ratings for disease severity (as determined by APACHE II and SOFA scores) were also characteristics of the group with a greater GRV. In addition, compared to the lower GRV group, more patients in the higher GRV group reported experiencing illness and vomiting. Patients with higher APACHE II and SOFA scores were more likely to have a GRV larger than 250 ml. Additionally, it was shown that the rise in GRV was greater in individuals who did not survive compared to those who did.
Conclusions: Elevated GRV wasn’t related to a higher incidence of VAP, duration of stay in the ICU, or death. As a result, it is not advised for critically sick patients to routinely assess GRV, a crucial component of the VAP preventive bundle.
Keywords: intensive care unit, gastric, ventilator-associated pneumonia