Intermittent versus continuous enteral nutrition in critically ill children: A pre-planned secondary analysis of an international prospective cohort study

Martinez, Enid E.; Bechard, Lori J.; Brown, Ann‐Marie; Coss‐Bu, Jorge A.; Kudchadkar, Sapna R.; Mikhailov, Theresa A.; Srinivasan, Vijay; Staffa, Steven J.; Verbruggen, Sascha; Zurakowski, David; Mehta, Nilesh M.

doi:10.1016/j.clnu.2022.09.018

Cited by 4 publications

(2 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As far as the time needed to reach total energy caloric intake is concerned, the results of the available evidence are conflicting due to the differences in methodology, small sample size, and outcome evaluation [ 22 , 24 ]. Results from a cohort study conducted by Martinez and their colleagues, which included 1375 patients in PICU, revealed that 66% of children assigned to the bolus group and 77.4% assigned to the continuous group managed to achieve 60% of the energy requirements within seven days [ 26 ]. Interestingly, a number of studies have also evaluated the continuous versus the bolus feeding in adult patients with opposing results [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Continuous versus Intermittent Enteral Feeding in Critically Ill Children: A Systematic Review

et al. 2023

View full text Add to dashboard Cite

Administration of enteral nutrition (EN) in critically ill pediatric patients admitted to the pediatric intensive care unit (PICU) constitutes a major challenge due to the increased risk of complications, as well as the lack of well-trained healthcare professionals. EN is usually delivered via cyclic, continuous, or intermittent feeding; however, a number of potential barriers have been reported in the literature regarding different feeding regimens. The purpose of this review was to assess the effectiveness of continuous and intermittent bolus feeding on critically ill children. A systematic search was conducted in PubMed, Scopus Cochrane Central Register of Controlled Trials (CENTRAL) and a clinical trial registry up to September 2022, including randomized controlled trials (RCTs) published in the English language. Four studies met the inclusion criteria with a total population of 288 patients admitted to the PICU. Three studies were rated with a high risk of bias and one with some concerns. There was high heterogeneity between the studies in regard to the reporting of outcomes. Three studies measured the total time needed to reach prescribed caloric intake with conflicting results, while two studies evaluated the length of stay (LOS) in PICU with no difference between the two arms. One study assessed the time weaning from mechanical ventilation, favoring the bolus group. No data were provided for gastric residual volume (GRV), anthropometric measurements, and biochemical markers. Additional randomized trials with better methodology are needed to assess the efficacy of the two enteral feeding regimens in critically ill PICU patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Continuous versus Intermittent Enteral Feeding in Critically Ill Children: A Systematic Review

et al. 2023

View full text Add to dashboard Cite

show abstract

“…The largest RCT, 70 patients per study arm, identified that intermittently fed patients achieved their nutrition goal 2 h earlier than continuously fed patients [62]. A recent, international, multicenter-study using prospectively collected data on EN delivery in mechanically ventilated children, did not show a difference between intermittently and continuously fed patients in the time to achieve nutritional goal and the frequency of acquired infections [63 ▪ ]. Other potential benefits from intermittent feeding associated with the promotion of physiologic EE signaling on the microbiome, immune regulation, and circadian health are possible.…”

Section: Enteroendocrine Cells and Clinical Implications In Critical ...mentioning

confidence: 99%

The enteroendocrine axis and its effect on gastrointestinal function, nutrition, and inflammation

Philpott,

Rodriguez Hovnanian,

Stefater-Richards

et al. 2024

Current Opinion in Critical Care

Self Cite

View full text Add to dashboard Cite

Purpose of review Gastrointestinal (GI) dysfunction limits enteral nutrition (EN) delivery in critical illness and contributes to systemic inflammation. The enteroendocrine (EE) axis plays an integral role in this interface between nutrition, inflammation, and GI function in critical illness. In this review, we present an overview of the EE system with a focus on its role in GI inflammation and function. Recent findings Enteroendocrine cells have been primarily described in their role in macronutrient digestion and absorption. Recent research has expanded on the diverse functions of EE cells including their ability to sense microbial peptides and metabolites and regulate immune function and inflammation. Therefore, EE cells may be both affected by and contribute to many pathophysiologic states and interventions of critical illness such as dysbiosis, inflammation, and alternative EN strategies. In this review, we present an overview of EE cells including their growing role in nonnutrient functions and integrate this understanding into relevant aspects of critical illness with a focus on EN. Summary The EE system is key in maintaining GI homeostasis in critical illness, and how it is impacted and contributes to outcomes in the setting of dysbiosis, inflammation and different feeding strategies in critical illness should be considered.

show abstract

Comparison of Protocol-Based Continuous and Intermittent Tube Feeding in Mechanically Ventilated Critically Ill Children – An Open Label Randomized Controlled Trial

Kumar,

Sankar,

Jana

et al. 2023

Indian J Pediatr

View full text Add to dashboard Cite

Intermittent versus continuous enteral nutrition in critically ill children: A pre-planned secondary analysis of an international prospective cohort study

Cited by 4 publications

References 24 publications

Continuous versus Intermittent Enteral Feeding in Critically Ill Children: A Systematic Review

Continuous versus Intermittent Enteral Feeding in Critically Ill Children: A Systematic Review

The enteroendocrine axis and its effect on gastrointestinal function, nutrition, and inflammation

Comparison of Protocol-Based Continuous and Intermittent Tube Feeding in Mechanically Ventilated Critically Ill Children – An Open Label Randomized Controlled Trial

Contact Info

Product

Resources

About