Rethinking gastric residual monitoring in PICU

Automatic transcript, lightly edited for readability. It may contain errors, so check it against the video before quoting.

So I'm going to talk a bit today about the GASTRIC-PICU trial, which was a trial led by myself as a intensive care nurse. This was a practice that we had historically done. So I wanted to challenge this. There had been evidence in adults that it wasn't really useful.

So we did a randomised control trial, recruited 4,700 children from across 24 UK and one Swiss PICU over the last two and a half years, and we found that not measuring gastric residual was no worse nor inferior than measuring gastric residual in terms of length of time on ventilation and any impact on mortality. On the upside, we also found that it was actually beneficial in terms of energy target achievement at 72 hours and it was minimal impact, but it was nevertheless a positive impact.

And I think I guess the key message from this trial is that there's lots of things that we've done in intensive care for many years that are probably ineffective, low value, but we've done them historically and we've never really challenged those practices. And I think this is the future of critical care. How much more we can make in terms of discovery, it's unclear. But what we can do is try and look at not wasting resources, not wasting staff time, and not actually having an impact of harm, potentially harm on children by doing things that we don't need to do.