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ABSTRACT
BACKGROUND
Recent trials have shown controversial results on which enteral feeding methods has a lower risk of enteral feeding intolerance. Therefore, we aimed to compare two methods of bolus and intermittent feeding on enteral feeding intolerance of patients with sepsis.
METHODS
This triple-blind randomized controlled trial was conducted on 60 patients with sepsis, who were fed through tubes for at least 3 days. The patients were randomly assigned into bolus feeding, intermittent feeding, and control groups. Enteral feeding intolerance of all patients was recorded in 3 consecutive days by a researcher-made checklist including the data on gastric residual volume, vomiting, diarrhea, constipation, and abdominal distension.
RESULTS
There were no significant differences between the three studied groups in none of the intervention days pertaining to constipation, diarrhea, vomiting, abdominal distention, and gastric residual volume (p > 0.05). Also, no statistically significant difference was found between all variables in the three studied groups during the 3 days (p > 0.05).
CONCLUSION
As enteral feeding intolerance of patients with sepsis was similar in both bolus and intermittent feeding methods, it can be concluded that bolus method can still be used as a standard method to decrease the risk of enteral feeding intolerance if it is used properly.
KEYWORDS:
Feeding methods, Enteral feeding, Feeding intolerance, Sepsis, Intensive care unit
INTRODUCTION
Nutritional support is considered as essential parts of the management of critically ill patients in the intensive care units (ICUs).1,2 Typically, nutritional support of most critically ill hospital inpatients with a functional gastrointestinal tract, who are unable to meet their nutritional needs orally, are provided by enteral feeding (EF) using nasogastric tubes (NGTs).3,4 Although EF decrease the mortality of undernourished critically ill patients and has shown promising clinical outcomes, most of the patients fed by tube show symptoms of feeding tube-associated intolerance such as vomiting, diarrhea, constipation, abdominal distention, regurgitation, and high gastric residual volume (GRV).5,6
Method of EF has been shown as one of the main factors in the incidence of EF intolerance in critically ill patients.7,8 Based on Dietitians Association of Australia (DAA), EF can be administered by continuous, intermittent (cyclic/intermittent), and bolus methods based on patients' medical conditions and nutritional requirements.9 Most recent trials have compared EF intolerance of continuous feeding with either bolus,10-12...