Gastric dysmotility is common in critically ill patients. The pathophysiology is multifactorial including the severity and etiology of the underlying critical illness, use of narcotic analgesia and other sedatives, decreased blood flow from shock, and use of vasopressors. Gastric dysmotility results in delayed gastric emptying that may place patients at risk of developing complications such as vomiting, aspiration, and ventilator-associated pneumonia (VAP). To manage this risk, guidelines recommend monitoring gastric residual volumes (GRVs) on an intermittent schedule and holding enteral feedings when residual volumes exceed certain limits.
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