Document Detail


Prospective randomized control trial of intermittent versus continuous gastric feeds for critically ill trauma patients.
MedLine Citation:
PMID:  17622869     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Jana B A MacLeod; Jennifer Lefton; Doug Houghton; Christina Roland; James Doherty; Stephen M Cohn; Erik S Barquist
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of trauma     Volume:  63     ISSN:  1529-8809     ISO Abbreviation:  J Trauma     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-11     Completed Date:  2007-08-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  57-61     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Emory University, Atlanta, Georgia, USA.
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MeSH Terms
Descriptor/Qualifier:
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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