Can they stomach it? Parent and practitioner acceptability of a trial comparing Gastric Residual Volume measurement versus no Gastric Residual Volume in UK NNU and PICU’s : a feasibility study

Deja, B; Roper, L; Tume, LN; Dorling, J; Gale, C; Arch, B; Latten, L; Pathan, N; Ecclesone, H; Hickey, H; Preston, J; Beissel, A; Andrzejewska, I; Valla, FV; Woolfall, K

Abstract

Background: Routine measurement of gastric residual volume (GRV) to guide feeding in neonatal and paediatric intensive care is widespread. However, this practice is not evidence based and may cause harm. As part of a feasibility study we explored parent and practitioner views on the acceptability of a trial comparing GRV measurement or no GRV measurement.
Methods: A mixed- methods study involving interviews and focus groups with practitioners and interviews with parents with experience of tube feeding in neonatal and/or paediatric intensive care. A voting system recorded closed question responses during practitioner data collection, enabling the collection of quantitative and qualitative data. Data were analysed using thematic analysis and descriptive statistics.
Results: We interviewed 31 parents and nine practitioners and ran five practitioner focus groups (n=42). Participants described how the research question was logical, the intervention would not be invasive and potential benefits of not withholding the child’s feeds. However, both groups held concerns about the potential risk of not measuring GRV, including delayed diagnosis of infection and gut problems, increased risk of vomiting into lungs and causing discomfort or pain. Parent’s views on GRV measurement and consent decision making were influenced by their views on the importance of feeding in the ICU, their child’s prognosis and associated comorbidities or complications.
Conclusions: The majority of parents and practitioners viewed the proposed trial as acceptable. Potential concerns and preferences were identified that will need careful consideration to inform the development of the proposed trial protocol and staff training.

Citation

Deja, B., Roper, L., Tume, L., Dorling, J., Gale, C., Arch, B., …Woolfall, K. (2021). Can they stomach it? Parent and practitioner acceptability of a trial comparing Gastric Residual Volume measurement versus no Gastric Residual Volume in UK NNU and PICU’s : a feasibility study. Pilot and Feasibility Studies, 7(1), 49. https://doi.org/10.1186/s40814-021-00784-5

• Journal Article Type: Article
• Acceptance Date: Jan 26, 2021
• Publication Date: Feb 16, 2021
• Deposit Date: Jan 27, 2021
• Publicly Available Date: Feb 17, 2021
• Journal: Pilot and Feasibility Studies
• Print ISSN: 2055-5784
• Publisher: BioMed Central
• Volume: 7
• Issue: 1
• Pages: 49
• DOI: https://doi.org/10.1186/s40814-021-00784-5
• Publisher URL: https://doi.org/10.1186/s40814-021-00784-5
• Related Public URLs: https://pilotfeasibilitystudies.biomedcentral.com/
• Additional Information: Funders : National Institute for Health Research (NIHR) Health Technology Assessment;Medicines for Children Clinical Trials Unit;University Hospitals Bristol (UHB) NHS Foundation Trust; Projects : Is it feasibility to conduct a trial of NO GRV measurements in UK PICUs and NICUs; Grant Number: 16/94/02