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Enhancing Interpretation of Gastric Residual Volume by Refractometry

Wei-Kuo Chang, MD, PhD^*
Stephen A. McClave, MD
You-Chen Chao, MD^*

^* Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China; and Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky

Correspondence: Correspondence: Stephen A. McClave, MD, Professor of Medicine, Division of Gastroenterology/Hepatology, University of Louisville School of Medicine, 550 S. Jackson Street, Louisville, KY 40202. Electronic mail may be sent to samcclave{at}louisville.edu.

The traditional practice of gastric residual volumes (GRVs) is flawed in its design and conception, is poorly standardized in its technique, is an inaccurate measure of gastric emptying, and serves as an insensitive marker for regurgitation and aspiration. The refractive index of a solution (like an enteral formula) is a physical property of that solution, which is remarkably constant and reproducible under varying conditions of concentration, pH, and temperature. Refractometry may be performed quickly and easily at the bedside, requires only a small representative sample of aspirated solution, and provides valuable measurements that can be used to calculate both the true total volume of contents and the specific volume of formula remaining in the stomach. Refractometry complements the use of GRVs as a monitor for patients receiving enteral feeding and should improve the accuracy with which patients at risk for aspiration may be identified.

Nutrition in Clinical Practice, Vol. 19, No. 5, 455-462 (2004)
DOI: 10.1177/0115426504019005455


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