Gastric motility and gastric emptying are impaired during critical illness, although small-bowel absorption and motility is often adequate to maintain enteral nutrition. Large gastric aspirates can delay or prevent intragastric tube feeding. Large nasogastric aspirates prevent enteral feeding in 17 per cent of patients and are the most common reason for decreasing or stopping it. Gastric residual volumes of 150 to 300 ml, or less than twice the hourly volume of feed being given, have been used to define the upper limit of 'normal'. Patients with residual volumes of less than 300 ml usually tolerate gastric feeding, but larger residual volumes require gastric tube decompression and transpyloric feeding.

Large gastric aspirates increase the risk of regurgitation, vomiting, and aspiration of stomach contents, particularly in patients who are sedated or whose consciousness or bulbar function is impaired.

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