Critical Care

, 7:P209 | Cite as

Gastric residual volume and the paracetamol gastric motility test in critically ill patients

  • V Zidianakis
  • Th Niarchou
  • P Miriantheus
  • E Mboutzouka
  • G Baltopoulos
Meeting abstract


Paracetamol Trauma Patient Nasogastric Tube Gastric Content Gastric Motility 
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To evaluate the paracetamol absorption test in comparison with the clinical test of gastric residual volume, as indicators of gastric motility, in order to initiate peros feeding in critically ill patients.


A prospective self-controlled study, evaluating a clinical and a laboratory test.


An adult medical–surgical university ICU.

Patients and methods

All patients were studied in three steps. Step I. The gastric residual volume was measured 1 hour (by aspiration of the gastric content) after the delivery of 200 ml D5W (gastric residual volume test [GRVT]) via a nasogastric tube in 18 mechanically ventilated critically ill trauma patients (mean age ± SEM 51.31 ± 4.92 years). Step II. One gram of paracetamol was delivered via the nasogastric tube, and blood samples were drawn at time (t) 0 and 30, 60 and 90 min post paracetamol administration. The paracetamol was administered immediately after step I. Step III. A try (commercial liquid food) of peros feed was given in all studied patients right after the 90 min blood sample was drawn.

All patients were divided in two groups. Group A (n = 10): patients tolerated the peros feeding and were successfully fed peros thereafter. Group B (n = 8): patients not tolerated the peros feeding. The peros feeding was not achieved the day of the study.


The mean (± standard error) GRV and paracetamol serum levels were as presented in Table 1. In all Group A patients the residual gastric volume was ≤ 100 ml (mean ± standard error = 58.0 ± 9.5), whereas in all Group B patients it always was > 100 ml (mean ± standard error = 208.0 ± 18.7). All Group A patients were successfully fed whereas no one of the Group B was successfully fed the day of the study.

Table 1


GRV (ml)

0 min

30 min

60 min

90 min

Group A

58.0 ± 9.5

0.11 ± 0.08

2.79 ± 0.83

3.69 ± 0.89

4.17 ± 0.88

Group B

208.0 ± 18.7

0.67 ± 0.26

3.01 ± 1.8

2.91 ± 1.36

2.35 ± 0.96

P value*

< 0.0001

> 0.05

> 0.05

> 0.05

< 0.05

GRV, gastric residual volume. * Between Groups A and B, Mann–Whitney U test.

No statistically significant differences (Mann–Whitney U test) were observed in blood paracetamol levels between groups at baseline, 30 and 60 min. A statistically significant difference was observed at 90 min, reflecting the higher blood paracetamol levels of Group A, which was the successfully peros-fed group.


The GRVT is a fast (within 1 hour) clinical tool for decision making to peros feed a critically ill patient. A gastric residual volume < 100 ml is indicative of a successful peros feeding in our critically ill patients. The higher paracetamol blood levels at 90 min post paracetamol administration does not seem to be a useful tool in the peros feeding decision-making process. It happens because on one hand it is a time-consuming and work-consuming process and on the other hand there is not a cutoff paracetamol serum level, which separates the peros food-tolerating patients.

Copyright information

© BioMed Central Ltd 2003

Authors and Affiliations

  • V Zidianakis
    • 1
  • Th Niarchou
    • 1
  • P Miriantheus
    • 1
  • E Mboutzouka
    • 1
  • G Baltopoulos
    • 1
  1. 1.Athens University School of Nursing ICU at KAT HospitalKumamotoGreece

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