Continuous Versus Intermittent Enteral Feeding in Critically Ill Patients

Seoul National University

Status: Unknown

Conditions: Nutrition Disorders

Treatments: Other: Continuous enteral feeding via infusion pump; Other: Intermittent enteral feeding via gravity-based infusion

Study type: Interventional

Funder types: Other

Identifiers

NCT02159456

feed520

Details and patient eligibility

About

1. Nutritional support during critical illness is important to improve the clinical outcome of patients. Recently, the apply of early enteral nutrition is recommend in critically ill patients on basis of data that enteral nutrition can be helpful to prevent the hospital-acquired infections.

   • However, in critically ill patients, the smooth progress of nutritional support is often hindered by gastrointestinal intolerance, underlying clinical condition, and temporal necessity of procedure or operation.
   • Continuous feeding method, compared with intermittent feeding, is expected to reduce the risk of gastrointestinal intolerance, and improve the nutritional support, but this hypothesis is not supported by appropriate evidences.

2. We will elucidate to compare the efficacy and safety of the continuous feeding method in critically ill patients, compared with the intermittent feeding method.

   • Prospective, randomized controlled study
   • Primary outcome: the achievement rate of target nutritional goal within 7 days after the start of enteral nutrition
   • Secondary outcome: gastrointestinal tolerance, In-ICU/hospital mortality, frequency of hospital-acquired infection, ICU/hospital length-of-stay, duration of mechanical ventilation

Enrollment: 70 estimated patients

Sex: All

Ages: 20+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• adult patient admitted in the intensive care unit
• age 20 years old or more
• The enteral nutritional support is expected to be available within 48 hours after ICU admission

Exclusion criteria

• previous abdominal surgery within 1 month
• gastrointestinal bleeding, bowel obstruction, refractory vomiting/diarrhea
• hypersensitivity to prokinetics, history of seizure or phechromocytoma
• enteral feeding via enterostomy or gastrostomy
• difficulty to insert or maintain nasogastric tube
• need for specialized feeding (ex: hemodialysis diet, chronic renal failure diet, diabetes diet)
• pregnancy

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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70 participants in 2 patient groups

Continuous enteral feeding

Experimental group

Description:

Continuous enteral feeding via infusion pump is applied for at least 7 days after the start of enteral feeding

Treatment:

Other: Continuous enteral feeding via infusion pump

Intermittent enteral feeding

Active Comparator group

Description:

Intermittent enteral feeding via gravity-based infusion is applied for at least 7 days after the start of enteral feeding.

Treatment:

Other: Intermittent enteral feeding via gravity-based infusion