In postoperative high GRV, which feeding route yields adequate calories?

In postoperative high GRV, which feeding route yields adequate calories?

• A. Oral feeding
• B. Nasogastric bolus feeding
• C. Small-bowel continuous feeding
• D. Total parenteral nutrition

Answer: (C)

When the patient has a high gastric residual volume after surgery, the stomach isn’t emptying well, so delivering nutrition into the stomach is often poorly tolerated and can be interrupted by residual checks, making it hard to meet caloric goals. Feeding directly into the small bowel bypasses the stomach and takes advantage of the still-functioning distal gut to absorb nutrients, which is more reliable when gastric emptying is impaired. Delivering this small-bowel nutrition as a continuous feed helps maintain a steady rate of calories and minimizes intolerance compared with rapid bolus dosing, reducing the risk of cramping, dumping-like symptoms, or aspiration. Total parenteral nutrition would supply calories without using the gut, but it is generally less favorable when the gut can be used due to infection risk, cost, and metabolic complications, and it doesn’t preserve gut integrity the way enteral feeding does. Therefore, the approach that yields adequate calories in this situation is small-bowel continuous feeding.

When the patient has a high gastric residual volume after surgery, the stomach isn’t emptying well, so delivering nutrition into the stomach is often poorly tolerated and can be interrupted by residual checks, making it hard to meet caloric goals. Feeding directly into the small bowel bypasses the stomach and takes advantage of the still-functioning distal gut to absorb nutrients, which is more reliable when gastric emptying is impaired. Delivering this small-bowel nutrition as a continuous feed helps maintain a steady rate of calories and minimizes intolerance compared with rapid bolus dosing, reducing the risk of cramping, dumping-like symptoms, or aspiration. Total parenteral nutrition would supply calories without using the gut, but it is generally less favorable when the gut can be used due to infection risk, cost, and metabolic complications, and it doesn’t preserve gut integrity the way enteral feeding does. Therefore, the approach that yields adequate calories in this situation is small-bowel continuous feeding.