I read with interest the article by Metheny and colleagues11 in the November 2008 issue. The authors state that ”as much fluid as possible” was withdrawn in order to calculate gastric residual volume (GRV) in the study, but I saw no mention of whether a standardized withdrawal technique was used.

Although it may seem simplistic, I have found that a first quick pull of the syringe often suggests that little or no GRV exists. Yet when the syringe is slowly and patiently “nursed” (ie, through gentle aspiration, reinstallation when a vacuum lock is felt, then repeating), one often finds aspirate volumes far greater than initially obtained.

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