| Prospective randomized control trial of intermittent versus continuous gastric feeds for critically ill trauma patients. | |
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MedLine Citation:
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PMID: 17622869 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: This study compared an intermittent feeding regimen (one-sixth of daily needs infused every 4 hours) with a continuous (drip) feeding regimen for critically ill trauma patients. There were two outcome variables: time to reach goal volume and the days on 100% of caloric needs via an enteral route in the first 10 days of the intensive care unit stay. Adverse events were also tallied. METHODS: A prospective randomized trial was conducted in the trauma intensive care unit in a university Level I trauma center. A total of 164 trauma patients, 18 years of age and older were admitted to the trauma intensive care unit with a noninjured gastrointestinal tract and required more than 48 hours of mechanical ventilation. Patients were randomized to receive enteral nutrition via an intermittent feeding regimen versus a continuous feeding regimen. A single nutritionist calculated caloric and protein goals. A strict protocol was followed where hourly enteral intake, interruptions and their causes, diarrhea, and pneumonia were recorded, as well as standard guidelines for intolerance. RESULTS: A total of 164 patients were randomized and 139 reached their calculated nutritional goal within 7 days. There were no statistical differences in complications of tube feeding. The patients intermittently fed reached the goal faster and by day 7 had a higher probability of being at goal than did the patients fed continuously (chi = 6.01, p = 0.01). Intermittent patients maintained 100% of goal for 4 of 10 days per patient (95% CI = 3.5-4.4) as compared with the drip arm goal for only 3 of 10 days per patient (95% CI = 2.7-3.6). CONCLUSIONS: Patients from both the intermittent and continuous feeding regimens reached the goal during the study period of 7 days but the intermittent regimen patients reached goal enteral calories earlier. The intermittent gastric regimen is logistically simple and has equivalent outcomes to a standard drip-feeding regimen. |
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Authors:
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Jana B A MacLeod; Jennifer Lefton; Doug Houghton; Christina Roland; James Doherty; Stephen M Cohn; Erik S Barquist |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: The Journal of trauma Volume: 63 ISSN: 1529-8809 ISO Abbreviation: J Trauma Publication Date: 2007 Jul |
Date Detail:
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Created Date: 2007-07-11 Completed Date: 2007-08-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376373 Medline TA: J Trauma Country: United States |
Other Details:
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Languages: eng Pagination: 57-61 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, Emory University, Atlanta, Georgia, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Critical Illness Energy Intake Enteral Nutrition / methods* Female Humans Male Middle Aged Wounds and Injuries / therapy* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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