Discussion
Gastric emptying may be affected in critical illness and
contributes to EN intolerance [16–19]. The use of GRV as
a tool to evaluate gastric tolerance to EN is accepted as a
clinical routine and has been incorporated in nutritional
support algorithms in many ICUs [20, 21]. Our working
hypothesis was that a limit higher than the 200–250-ml
current limit could be used and that this could serve as a
‘‘rescue’’ mechanism for maintaining EN in patients with
GRV in the range of 200–500 ml, without increasing
complications. We decided to select a limit of 500 ml for
GRV in the study group because this value has been
suggested in the literature as a clinical end-point needing
evaluation [10].