OBJECTIVE: To determine optimal outcome measures for a trial of not routinely measuring gastric residual volume in neonatal care.
METHODS: A focused literature review, parent interviews, modified two-round Delphi survey and stakeholder consensus meeting.
METHODS: Sixty-one neonatal healthcare professionals participated in an eDelphi survey; 17 parents were interviewed. 19 parents and neonatal healthcare professionals took part in the consensus meeting.
RESULTS: Literature review generated 14 outcomes, and parent interviews contributed eight additional outcomes; these 22 outcomes were then ranked by 74 healthcare professionals in the first Delphi round where four further outcomes were proposed; 26 outcomes were ranked in the second round by 61 healthcare professionals. Five outcomes were categorised as \'consensus in\', and no outcomes were voted \'consensus out\'. \'No consensus\' outcomes were discussed and voted on in a face-to-face meeting by 19 participants, where four were voted \'consensus in\'. The final nine consensus outcomes were: mortality, necrotising enterocolitis, time to full enteral feeds, duration of parenteral nutrition, time feeds stopped per 24 hours, healthcare-associated infection; catheter-associated bloodstream infection, change in weight between birth and neonatal discharge and pneumonia due to milk aspiration.
CONCLUSIONS: We have identified outcomes for a trial of no routine measurement of gastric residual volume to guide feeding in neonatal care. This outcome set will ensure outcomes are important to healthcare professionals and parents.
目的:为一项在新生儿护理中不常规测量胃残余体积的试验确定最佳结局指标。
方法:重点文献综述,家长访谈,修改后的两轮德尔福调查和利益相关者共识会议。
方法:61名新生儿保健专业人员参加了eDelphi调查;17名父母接受了采访。19名父母和新生儿保健专业人员参加了共识会议。
结果:文献综述产生了14个结果,和家长访谈贡献了8项额外的结果;这22项结果在第一轮Delphi中由74名医疗保健专业人员进行排名,其中4项进一步的结果被提出;26项结果在第二轮中由61名医疗保健专业人员进行排名.五个结果被归类为“共识”,没有结果被投票“协商一致”。19名与会者在面对面会议上讨论并表决了“没有达成共识”的结果,其中四人被投票赞成“协商一致”。最后九项共识结果是:死亡率,坏死性小肠结肠炎,完全肠内喂养的时间,肠外营养的持续时间,每24小时停止喂食的时间,医疗保健相关感染;导管相关血流感染,出生和新生儿出院之间的体重变化以及吸奶引起的肺炎。
结论:我们已经确定了一项没有常规测量胃残留量以指导新生儿护理喂养的试验结果。此结果集将确保结果对医疗保健专业人员和父母很重要。