Evidence map›Paper›PMID 41501913›Full record

ArticleTrials2026

Avoiding routine gastric residual volume measurement in neonatal critical care (the neoGASTRIC trial): study protocol for a multi-centre, unblinded, randomised, controlled trial.

Elizabeth Nuthall, Amy Rodriquez, Iza Andrzejewksa, Zainab Aslam, Cheryl Battersby, Catherine Beesley, Christina Cole, Helen Campbell, Kim Dalziel, Jon Dorling and 30 more

Abstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

40 authors.

Elizabeth NuthallNational Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, UK.
Amy RodriquezDepartment of Paediatrics, Monash Newborn, Monash Children's Hospital, Monash University, Clayton, Australia.
Iza AndrzejewksaChelsea and Westminster Hospital, Neonatal Intensive Care Unit, London, UK.
Zainab AslamNational Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, UK.
Cheryl BattersbyNeonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, London, UK.
Catherine BeesleyConsumer Advisory Group, NHMRC CRE in Newborn Medicine, Murdoch Children's Research Institute, Parkville, Australia.
Christina ColeNational Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, UK.
Helen CampbellNational Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, UK.
Kim DalzielHealth Economics Group, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
Jon DorlingUniversity of Leeds, Leeds, UK.
Alan DownsNational Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, UK.
Peter G DavisThe Royal Women's Hospital, University of Melbourne, Melbourne, Australia.
Zoe DaskalopoulouNational Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, UK.
Amanda ForsterJames Cook University Hospital, Middlesbrough, UK.
Michaela Graham-TravisNational Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, UK.
Nigel J HallUniversity Surgery Unit, Faculty of Medicine, University of Southampton, Southampton, UK.
Marie HubbardUniversity Hospitals of Leicester NHS Trust, Leicester, UK.
Madeleine HurdNational Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, UK.
Pollyanna HardyNational Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, UK.
Rod HuntDepartment of Paediatrics, Department of Neonatal Medicine, Monash University, Monash Health Cerebral Palsy Alliance, University of Sydney, Sydney, Australia.
Ann KennedyNational Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, UK.
Andrew KingNational Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, UK.
Louise LinsellUniversity of Oxford, Oxford, UK.
Brett J ManleyDepartment of Obstetrics and Gynaecology, Mercy Perinatal, Mercy Hospital for Women, The University of Melbourne, Melbourne, Australia.
David MurrayNational Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, UK.
Tracy K MitchellDepartment of Public Health Policy and Systems, University of Liverpool, Liverpool, UK.
Heather O'ConnorNational Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, UK.
Shalini OjhaUniversity of Nottingham, Nottingham, UK.
Charles C RoehrNational Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, UK.
Oliver Rivero-AriasNational Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, UK.
Kayleigh StanburyNational Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, UK.
Jacqueline TaylorDepartment of Paediatrics, Monash Newborn, Monash Children's Hospital, Monash University, Clayton, Australia.
Lyvonne TumeEdge Hill University, Ormskirk, Alder Hey Children's NHS FT, Liverpool, UK.
Richard WelshNational Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, UK.
Joy WilesNational Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, UK.
Kerry WoolfallDepartment of Public Health Policy and Systems, University of Liverpool, Liverpool, UK.
Lauren YoungSSNAP (Support for Sick Newborn and Their Parents), Oxford, UK.
Calum RobertsDepartment of Paediatrics, Monash Newborn, Monash Children's Hospital, Monash University, Clayton, Australia.
Chris GaleChelsea and Westminster Hospital, Neonatal Intensive Care Unit, London, UK. christopher.gale@imperial.ac.uk.ORCID http://orcid.org/0000-0003-0707-876X
neoGASTRIC collaborative group

Funding

Health Technology Assessment Programme NIHR134216National Health and Medical Research Council NHMRC2014792
6 · The paper itself

Abstract

backgroundRoutine measurement of gastric residual volumes involves regularly aspirating the entire stomach contents to assess the volume and colour of the aspirate to inform feeding. This is an established practice in many United Kingdom and Australian neonatal units for preterm infants receiving gastric tube feeds. The rationale is to assess feed tolerance and to predict and potentially prevent necrotising enterocolitis, a serious gut condition. Routine measurement of gastric residual volumes may also be associated with adverse outcomes and harm, including delayed achievement of full enteral feeds and longer neonatal unit stay. Evidence to support the routine measurement of gastric residuals is poor, and previous small trials have not been generalisable to UK or Australian neonatal care.

methodsThe aim of the neoGASTRIC trial is to test whether avoiding routine measurement of gastric residual volumes in preterm infants reduces the time taken for an infant to reach full enteral feeds without increasing necrotising enterocolitis. neoGASTRIC is an individually randomised controlled trial in neonatal units in the UK and Australia. A target of 7040 infants born before 34 weeks' gestation will be randomly allocated, prior to receiving 24 h of enteral feeds > 15 ml/kg/day, on a 1:1 basis to have no routine gastric residual volumes measured, or to have gastric residual volumes measured routinely. Opt-out consent will be used with parent and staff views explored as part of an embedded process evaluation. The primary superiority outcome is time to reach full milk feeds ≥ 145 ml/kg/day for three consecutive days. Bell's stage 2 or 3 necrotising enterocolitis following blinded adjudication will be the key secondary, non-inferiority safety outcome. Other neonatal core outcomes and health care resource use and costs prior to discharge will be evaluated. DISCUSSION: neoGASTRIC will address a research priority that affects more than 20,000 preterm infants in the United Kingdom and Australia annually. Even modest improvements in clinical outcomes and resource use could result in large clinical benefits and savings at a population level.

trial registrationISRCTN 16710849 . Prospectively registered on 8 February 2023.

Indexed as

Enteral NutritionEnterocolitis, NecrotizingGastrointestinal ContentsInfant, PrematureIntensive Care, NeonatalAustraliaGestational AgeHumansInfant, NewbornMulticenter Studies as TopicPredictive Value of TestsRandomized Controlled Trials as TopicResidual VolumeTime FactorsUnited KingdomEnteral feedingFeeding intoleranceGastric residual volumeGastric tube feedsInfantNecrotising enterocolitis (NEC)Neonatal careNeonatal nutritionPretermProtocolRandomised controlled trial

Identifiers

PMID41501913
PMCPMC12874682

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.