Effects of continuous versus bolus infusion of enteral nutrition in critical patients

Abstract

Both administration modalities permitted practical and effective administration of the diet with frequent registered abnormalities but few clinically significant problems. The two groups were similar in this regard, without statistical differences, probably because of meticulous technique, careful monitoring, strict patient matching, and conservative amounts of diet employed in both situations. Further studies with additional populations, diagnostic groups, and dietetic prescriptions should be performed in order to elucidate the differences between these commonly used feeding modalities.

Nurse to Bed Ratio and Nutrition Support in Critically Ill Patients

“…1,2,[11][12][13][14] In those studies, the main causes of feeding interruption were gastrointestinal intolerance (gastric reflux, vomiting, or diarrhea), interruption for medical procedures, problems with the feeding tube, and airway management (extubation). 4,11,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Our study showed similar results. Few studies 12,16,22,28 evaluated the risk factors, intrinsic to the patient or not, that may predispose patients to interruption of enteral nutrition.…”

“…1,2,[11][12][13][14] The main factors responsible for the interruption of enteral nutrition are gastrointestinal intolerance (gastric reflux, vomiting, or diarrhea), procedures or examinations, problems with the feeding tube, and airway management. 4,[14][15][16][17][18][19][20][21][22][23][24][25][26][27] However, most previous studies involved evaluation of whether or not patients met their nutrition goals during the entire ICU stay rather than on a daily basis. Some factors that vary daily, such as doses of vasoactive and sedation drugs, have already been reported.…”

Ernährungssonden bei kritisch kranken Patienten

“…Eine abschließende Beurteilung der Vor und Nachteile einer kontinuierli chen, zyklischen, intermittierenden oder bolusweisen Gabe der Nahrung mit Be fürwortung einer Applikationsform kann bis dato nicht gestellt werden [29,33,36,58]. Es kann jedoch festgestellt werden, dass mit Zunahme der Kontinuität der Nahrungsapplikation eine leitlinienge rechte Medikamentengabe erschwert ist und die Gefahr der Interaktionen mit diesen Substanzen oder der intralumi nalen Verlegung der Sonde hierdurch er höht ist [67].…”

Enteral nutrition associated non-occlusive bowel ischemia

“…Enteral nutrition leads to tropism of enterocytes [7]. In the presence of luminal nutrients, splanchnic blood flow increases up to 200% that of baseline in response to the augmented demand of the intestinal mucosa, resulting in a regional blood-flow redistribution known as postprandial hyperemia [8]. …”