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Do we control gastric residuals unnecessarily in premature newborns? AGRA study: avoidance of gastric residual aspiration
  1. Selahattin Akar1 and
  2. Mehmet Turgut2
  1. 1Department of Neonatalogy, Adiyaman Universitesi Tip Fakultesi, Adiyaman, Turkey
  2. 2Department of Pediatrics, Adiyaman Universitesi Tip Fakultesi, Adiyaman, Turkey
  1. Correspondence to Dr Selahattin Akar; drselahattinakar{at}


Aspiration and evaluation of gastric residuals are commonly performed interventions before each feeding in intensive care units, especially in very low birthweight infants. However, there is no sufficient evidence about the necessity of routine gastric residual aspiration. In this study, we aimed to investigate the time to full enteral intake and the incidence of necrotizing enterocolitis (NEC) in preterm infants in the period with gastric residual aspiration performed before each feeding, and those in the period without gastric residual aspiration.

Methods Preterm infants with a gestational week ≤33 were included in the study. The group with gastric residual control before each feeding consisted of 169 infants, and the group without routine gastric residual aspiration included 122 infants.

Results The mean gestational week was 30.37±2.58 and 29.31±3.37 in the group with gastric residual control and in the group without routine residual control, respectively (p<0.05). Birth weight, male gender, and mode of delivery were similar between both groups. The time to full enteral intake was shorter in the group without routine residual control (p<0.05). Total durations of parenteral nutrition, ≥grade 2 NEC, weight at discharge and duration of hospitalization were similar between the groups. Duration of invasive mechanical ventilator support was shorter in the group without routine residual control.

Conclusion Avoidance of routine gastric residual aspiration in preterm infants shortens the time to full enteral intake without increasing the incidence of NEC.

  • neonatology

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  • Contributors SA designed, executed the study, and interpreted the results. MT analyzed the data, prepared the methodology, and performed literature searching.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Adiyaman University Ethics Committee (No: 2017/8-13). Written consent was received from families of the infants.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. Data is included in the main text.

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