Letters Section Editor: Jody W. Zylke, MD, Senior Editor.
Author Affiliations: Department of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany (Dr Elke; firstname.lastname@example.org); and Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, Ontario, Canada (Dr Heyland).
To the Editor: Dr Reignier and colleagues1 provided evidence that not measuring residual gastric volume and adjusting enteral nutrition except in the case of vomiting or regurgitation (intervention group) did not negatively affect clinical outcomes compared with checking residual gastric volume 4 times per day and adjusting enteral feeding rates if the volume exceeded 250 mL (control group). The conclusion given by the authors that monitoring residual gastric volume should be discontinued in all patients receiving mechanical ventilation and early enteral nutrition is, in our opinion, an overstatement, because we believe that the external validity of the trial is limited.
Elke G, Heyland D. Residual Gastric Volume and Risk of Ventilator-Associated Pneumonia. JAMA. 2013;309(20):2090–2091. doi:10.1001/jama.2013.4090