Increased Gastric Residual Volumes (GRV)

(With gastric or post-pyloric feeding)

1. If feeding through OG/NG tube, or if additional OG/NG tube in place (NJFT or post-pyloric feeding tube) check gastric residuals every 4-8 hours.
2. Ensure no evidence of new ileus (i.e. lack of bowel regimen, electrolyte abnormalities, recent abdominal operation, abdominal compartment syndrome, C. diff infection etc.) or bowel obstruction.
3. Re-infuse the entire gastric aspirate or administer an equivalent volume of ½ normal saline.
4. If GRV > 300 ml on two consecutive checks, notify physician.
5. Start Erythromycin 250 mg IV or oral every 6 hours or metoclopramide 10 mg IV every 6 hours and continue every 4 hour residual checks.

Hold enteral feeds only when ordered by physician.