Visceral Protein Increase Associated with Interrupt versus Continuous Enteral Hyperalimentation

Abstract

Periodic parenteral hyperalimentation, the interruption of feeding for a period of time each day, parallels the fasted vs fed state in the meal eater. The fasted state appears to be more physiologic and seems to be associated with an increase of visceral proteins. Intravenous hyperalimentation data that have been published seem to confirm this fact. The purpose of this study was to compare the effect of continuous enteral hyperalimentation and interrupt enteral hyperalimentation on the visceral protein compartment. Two groups of 10 afebrile matched control patients (group 1) were on continuous enteral hyperalimentation for 19 +/- 6 days with no improvement in serum albumin or serum transferrin levels. No changes were made in the feeding schedules of 10 of the patients. Feeding schedules of the other 10 patients were changed to an 8-hr interrupt enteral hyperalimentation with calories, protein, and volume being provided remaining the same. Repeat serum albumin and transferrin levels were obtained after 10 days. There was a significant increase in albumin and transferrin levels (p less than 0.005) in those patients changed to an interrupt feeding schedule.

Decision‐Making for Enteral Feeding Administration: The Why Behind Where and How

“…Pinchcofsky-Devin has reported superior visceral protein synthesis in patients fed with cyclic versus 24-hour continuous regimens. 40 Less-expensive, more-concentrated, hypertonic, complex nutrient formulas can be administered via the gastric route. Either elemental or polymeric formulas can be delivered into the jejunum with comparable tolerances.41 Hypertonic formulas may cause abdominal cramping and diarrhea when delivered at full concentrations to the intestines.…”