Comparison of the Efectiveness and Complications Between Continuous and Intermittent Enteral Nutrition in Intensive Care Unit Patientsy

Introduction: Enteral nutrition is the first choice in nutritional support of critically ill patients. Although continuous enteral nutrition is the most often, the selection of the safer and more effective nutrition method is still controversial. PURPOSE: The comparison of two methods of enteral nutrition in critically ill patients, continuous versus intermittent, regarding incidence of gastrointestinal and respiratory system complications as well as the achievement of optimal nutritional goal. Material and Method: A systematic review of related studies was conducted in English and Greek language published for the years 2010–2015. The search was carried out by using key-words in the electronic databases Pubmed, ScienceDirect, Scopus, Cochrane Library and possible grey literature has been also searched. A total of 621 studies were retrieved of which seven studies were included in the systematic review. Results: Statistically significant differences in the risk of gastrointestinal and respiratory complications between the two nutritional methods were not identified, except for constipation, which was more frequent in continuous enteral nutrition in one study (p=0.025), pulmonary aspiration (p=0.005) and pneumonia (p=0.000) which were also more frequent during continuous enteral nutrition in one study. Operational definition of complications showed significant heterogeneity between studies. Nutrition efficiency between two groups showed statistically significant differences, with the intermittent enteral nutrition in two studies to be significantly more effective in the probability of nutritional target achievement by day 7 (p=0.000 and x2=6.01, p=0.01) and continuous enteral nutrition to be better in delivered nutritional volume in the 1st day of nutrition in two studies (p<0.001 and p<0.05) and in the total days of nutritional target achievement (p=0.03) in another study. Conclusions: There is a need for better-designed studies with larger samples, to answer if a nutrition method has more advantage than the other. The incidence of complications between the two methods showed no statistically significant differences and the nutritional effectiveness seems to have been rather better in intermittent enteral feeding. For these reasons, intermittent enteral nutrition perhaps could be used more frequently, unlike the usual practice in ICU.

Category: Volume 56, N 1
Hits: 398 Hits
Created Date: 15-03-2017
Authors: Dimitrios Xythalis , Efstratios Vamvakas , Vassiliki Karra