Summary of findings for the main comparison. Routine monitoring of gastric residuals compared to no routine monitoring of gastric residuals for prevention of necrotising enterocolitis in preterm infants.
| Routine monitoring of gastric residuals compared to no routine monitoring of gastric residuals for prevention of necrotising enterocolitis in preterm infants | ||||||
| Patient or population: prevention of necrotising enterocolitis in preterm infants Setting: neonatal intensive care units Intervention: routine monitoring of gastric residuals Comparison: no routine monitoring of gastric residuals | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with no routine monitoring of gastric residuals | Risk with routine monitoring of gastric residuals | |||||
| Number of infants with NEC stage 2 or 3 | Study population | RR 3.07 (0.50 to 18.77) | 141 (2 RCTs) | ⊕⊕⊝⊝ LOWa | ||
| 14 per 1000 | 43 per 1000 (7 to 264) | |||||
| Number of infants with episodes of interruption of feeds (lasting ≥ 12 hours) | Study population | RR 2.07 (1.39 to 3.07) | 141 (2 RCTs) | ⊕⊕⊝⊝ LOWb,c | ||
| 296 per 1000 | 612 per 1000 (411 to 908) | |||||
| Time to reach full enteral feeds (days) | Mean time to reach full enteral feeds (days) was 0 | MD 3.92 higher (2.06 higher to 5.77 higher) | ‐ | 141 (2 RCTs) | ⊕⊕⊝⊝ LOWc | |
| Time to regain birth weight (days) | Mean time to regain birth weight (days) was 0 | MD 1.7 higher (0.01 higher to 3.39 higher) | ‐ | 80 (1 RCT) | ⊕⊕⊝⊝ LOWc | |
| Number of TPN days | Mean number of TPN days was 0 | MD 3.29 higher (1.66 higher to 4.92 higher) | ‐ | 141 (2 RCTs) | ⊕⊕⊝⊝ LOWc | |
| Number of infants with extrauterine growth restriction at discharge | Study population | RR 0.89 (0.75 to 1.05) | 80 (1 RCT) | ⊕⊕⊝⊝ LOWc | ||
| 925 per 1000 | 823 per 1000 (694 to 971) | |||||
| All‐cause mortality before discharge | Study population | RR 1.25 (0.36 to 4.32) | 80 (1 RCT) | ⊕⊕⊝⊝ LOWc | ||
| 100 per 1000 | 125 per 1000 (36 to 432) | |||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; MD: mean difference; RCT: randomised controlled trial; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence. High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
aImprecise due to small sample size and low event rate.
bPossibility of bias due to lack of blinding.
cImprecise due to small sample size.