Enteral Nutrition Tolerance And REspiratory Support (ENTARES) Study in preterm infants: study protocol for a randomized controlled trial

Table 1 Criteria for the interruption of enteral feeding

	Minor criteria	Major criteria
Physical examination	• Abdominal distension • Visible bowel ansa • Abdominal distension responsive to gastric suction/rectal stimulation	• Dyschromic abdominal wall • Abdominal distension not responsive to gastric detension/rectal stimulation • Painful abdomen
Regurgitations/vomits	• ≤ 2 episodes between 2 feeds or in the previous 3 h (if not fed)	• > 2 episodes between 2 feeds or in the previous 3 h (if not fed) • Bilious vomiting/hematemesis
Gastric residual volumes (GRVs)^a	• GRV < 100% of previous feed (bilious or with hematic fragments)	• Hematic/fecaloidal GRV • GRV ≥ 100% of previous feed
Alvus	• Mucous stools	• Hematic stools
Cardiorespiratory (CR) events	• ≥ 3 CR events^b/h	• ≥ 1 extreme CR event^c
0–1 minor criteria:	- Continue enteral feeding with increments as per protocol (max 30 mL/kg/day)
2 minor criteria:	- Stop increasing feeds, re-assess prior to the next feed, and evaluate GRV if not done before - If 2 minor criteria in at least 2 consecutive evaluations, consider reducing volume of feed
1 major criterion or 3 minor criteria:	- Interrupt enteral feeding and re-assess prior to the next feed

^aThe evaluation of GRVs is elective and according to the protocol of each research unit. GRVs are considered pathological according to minor and major criteria
^bCR events were defined as episodes of apnea lasting more than 20 s or more than 5 s if followed by desaturation or bradycardia, episodes of desaturation with blood oxygen saturation below 80%, and episodes of bradycardia with heart rate below 80 beats per minute
^cExtreme CR events were defined as CR events requiring resuscitation

ISSN: 1745-6215