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Nursing practice of routine gastric aspiration in preterm infants and its link to necrotizing enterocolitis: is the

Osama Mohamed Elsayed Ramadan1, Majed Mowanes Alruwaili2, Abeer Nuwayfi Alruwaili3

  • 1College of Nursing, Jouf University, Sakaka, Saudi Arabia, 72388. omramadan@ju.edu.sa.

BMC Nursing
|May 17, 2024
PubMed

Insights

Routine gastric aspiration in preterm infants does not prevent necrotizing enterocolitis (NEC). This study found no significant difference in NEC incidence or severity between infants who underwent gastric aspiration and those who did not.

Area of Science:

  • Neonatal Medicine
  • Nursing Research
  • Gastroenterology

Background:

  • Routine gastric residual aspiration in preterm infants is a common practice but its effectiveness in preventing necrotizing enterocolitis (NEC) is debated.
  • Nurses are key in performing gastric aspiration, necessitating evidence-based practice guidelines.

Purpose of the Study:

  • To evaluate the clinical relevance of gastric aspiration in reducing the risk and severity of NEC in preterm infants.
  • To inform nursing practice regarding gastric aspiration in neonatal intensive care units (NICUs).

Main Methods:

  • A quasi-experimental study involving 250 preterm infants across two NICUs in Egypt.
  • Infants were divided into two groups: gastric aspiration (n=125) and non-aspiration (n=125).
  • Comparison of feeding practices, gastric residuals, NEC incidence/severity (modified Bell's criteria), and risk factors (multivariate regression).

Main Results:

  • No significant baseline differences were observed between the groups.
  • Gastric residual characteristics and feeding outcomes showed no substantial differences.
  • Overall NEC incidence was 14-15% with no significant difference in onset or progression between groups.
  • Lower gestational age and birth weight were identified as stronger predictors of NEC.

Conclusions:

  • Routine gastric aspiration does not appear to directly prevent or reduce the severity of NEC in preterm infants.
  • While gastric residuals remain clinically relevant, the study questions the assumption that aspiration protects against NEC.
  • Findings support the evolution of evidence-based feeding protocols focusing on modifiable risk factors for NEC.

Keywords:
Evidence-based practiceFeed toleranceGastric aspirationGastric residualsNecrotizing enterocolitisPreterm infants

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