PT - JOURNAL ARTICLE AU - Ariel A Salas AU - Alain Cuna AU - Ramachandra Bhat AU - Gerald McGwin, Jr AU - Waldemar A Carlo AU - Namasivayam Ambalavanan TI - A randomised trial of re-feeding gastric residuals in preterm infants AID - 10.1136/archdischild-2014-307067 DP - 2015 May 01 TA - Archives of Disease in Childhood - Fetal and Neonatal Edition PG - F224--F228 VI - 100 IP - 3 4099 - http://fn.bmj.com/content/100/3/F224.short 4100 - http://fn.bmj.com/content/100/3/F224.full SO - Arch Dis Child Fetal Neonatal Ed2015 May 01; 100 AB - Objective To determine whether re-feeding of gastric residual volumes reduces the time needed to achieve full enteral feeding in preterm infants. Design Parallel-group randomised controlled trial with a 1:1 allocation ratio. Setting Regional referral neonatal intensive care unit. Patients 72 infants of gestational age 230/7 to 286/7 weeks receiving minimal enteral nutrition (<24 mL/kg/day) during the first week after birth. Interventions Infants were randomised to either be re-fed with gastric residual volumes (Re-feeding group) or receive fresh formula/human milk (Fresh-feeding group) whenever large gastric residual volumes were noted. Main outcome measure The primary efficacy end point was time to achieve full enteral feeding (≥120 mL/kg/day) after randomisation. Results The mean time to full enteral feeding was 10.0 days in the Re-feeding group and 11.3 days in the Fresh-feeding group (mean difference favouring re-feeding: −1.3 days; 95% CI −2.9 to 0.3; p=0.11). The composite safety end point of spontaneous intestinal perforation, surgical necrotising enterocolitis, or death occurred in 6 of 36 infants (17%) in the Re-feeding group versus 10 of 36 infants (28%) in the Fresh-feeding group (p=0.26). Conclusions Re-feeding gastric residual volumes in extremely preterm infants does not reduce time to achieve full enteral feeding. This trial suggests that re-feeding might be as safe as fresh feeding, but further research is needed, due to lack of sufficient statistical power in this study for safety analysis. Trial registration number NCT01420263NCT01420263.