~ 31 ~ International Journal of Research in Paediatric Nursing 2023; 5(1): 31-40 E-ISSN: 2664-1305 P-ISSN: 2664-1291 www.paediatricnursing.net IJRPN 2023; 5(1): 31-40 Received: 30-11-2022 Accepted: 16-01-2023 Dr. Eman ABD Elfattah Hassan Assistant Professor, Department of Pediatric Nursing, Faculty of Nursing, Cairo University, Egypt Samar Mahmoud Mohamed El- Hadary Lecturer, Department of Pediatric Nursing, Faculty of Nursing, Cairo University, Egypt Corresponding Author: Dr. Eman ABD Elfattah Hassan Assistant Professor, Department of Pediatric Nursing, Faculty of Nursing, Cairo University, Egypt Effect of returning versus discarding gastric residual volume on enteral feeding outcomes among critically ill children: A randomized control trial Dr. Eman ABD Elfattah Hassan and Samar Mahmoud Mohamed El- Hadary DOI: https://doi.org/10.33545/26641291.2023.v5.i1a.116 Abstract Background and Aim: Enteral feeding is the recommended and preferred feeding method for critically ill children with a functional gastrointestinal system because of its lower cost and complication rates when compared with parenteral nutrition. The study was aimed to evaluate the effect of returning versus discarding gastric residual volume on enteral feeding outcomes among critically ill children. Subjects and Method: randomized controlled trial comparison study was utilized to conduct the current study. A total sample of 100 critically ill children was recruited from pediatric intensive care unit of El-Monira Children Hospital-Cairo University and assigned randomly into the study and the control group. Data were collected by a structured interview questionnaire and Subjective Global Nutrition Assessment Form (SGNA). Results: there were a statistical significant difference in the total mean score of children' respiration and pulse at the 2 nd , 3 rd and 4 th day, sodium and potassium levels at 3 rd and 4 th day and a highly statistical significant difference between both groups regarding the SGNA at 1 st , 3 rd and 4 th day but there was no statistical significant difference between both groups at 2 nd day. Conclusion: Better feeding outcomes were seen in children who their residual volume was discarded. However, a majority of children followed the discarding method had lower electrolyte levels than the returning group. Keywords: Children, discarding, enteral feeding, returning, residual volume Introduction Enteral feeding (EF) is the recommended method of feeding for critically ill children with a functional gastrointestinal system since it is less expensive and has less complication than parenteral nutrition (PN) [1] . The American Society for Parenteral and Enteral Nutrition (AS- PEN) provides a definition of it as a method of supplying food directly into the gastro- intestinal system by a stoma, catheter, or tube, avoiding the nasal or mouth cavities [2] . Evidence based practices showed that early institution of EF for children that are critically ill are linked to beneficial consequences and has become more prevalent during critical illness [3] . Nonetheless, despite the proportional benefits, providing secure and efficient enteral feeding may still reveal challenges in terms of effort, expense, and technical expertise [4] . Subsequent maintenance of enteral nutrient delivery remains elusive and studies showed that EF In place of safe procedures that are supported by evidence, rituals and personal beliefs are used to implement practices, and critically ill children due to variations in practise, do not receive the required nutritional support [5] . Inappropriate delivery of EF is still a problem for critically ill children. Only 37% of children seeking intensive care received the recommended amount of calories, according to an international study [6] and many critically ill children do not achieve the goal of EF and are highly susceptible to problems include lung aspiration, feeding intolerance, and gastrointestinal retention [7] . In this population, It is frequently accompanied by significant gastric residual volumes, which could raise the risk of vomiting and regurgitation and delay the fulfillment of nutritional objectives [8] . To improve the outcomes of critically ill children, researchers must investigate ways to maximize the benefits and minimize the problems of feeding tubes for nutrition support. [3] .