Investigating the Effect of Two Methods of Continuous and Bolus Enteral Nutrition on Serum Albumin and Prealbumin levels in Patient with Mechanical Ventilation: A randomized clinical trial

Abstract

Background Patients with mechanical ventilation are unable to feed orally due to the acute condition and low level of consciousness, and therefore nutritional support is one of the main pillars of care in this area. Albumin and pre albumin proteins are indicators of nutritional adequacy in critically ill patients who receive enteral nutrition. The aim of this study was to determine the effect of continuous and bolus enteral feedings on serum albumin and prealbumin levels in patients with mechanical ventilation. Methods A parallel single-blind clinical trial study was conducted in Imam Khomeini, Iran, on 34 patients. Patients with mechanical ventilation admitted to the intensive care unit randomly divided into two intervention (17 patients) and control (17 patients) groups. The intervention group was fed by continuous feeding and the control group was fed by bolus feeding through nasogastric tube for one week. Before and one weeks after the start of the study, serum albumin and prealbumin levels of patients were measured. Data collected were entered into SPSS software version 16. The hypothesis was tested by paired and independent t-tests. Results No significant difference was found in serum albumin levels between the two groups, but prealbumin level was higher in the intervention group than in the control group (control group: 0.12 ± 0.06, intervention group: 0.02 ± 0.15 and p = 0.08). The serum levels of prealbumin in the intervention group at the end of the study had a significant increase compared to the beginning of the study (before the intervention: 0.11 ± 0.06, after the intervention: 0.15 ± 0.02 and p = 0.004). However, intra-group changes in albumin level in the control group were not statistically significant. Conclusion Continuous feeding method improved serum albumin levels in patients with mechanical ventilation. Therefore, the continuous feeding method could be an alternative to the bolus feeding method. Further research with more samples and longer follow-up is recommended. Trial registration The protocol of this clinical trial has been registered in the Iranian Clinical Trial Registration Center (registration code: IRCT20190128042528N1). date of first registration: 18/01/2020. https://www.irct.ir/.