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The Incidence and Characteristics of Gastrointestinal Intolerance on Mechanically Ventilated Patients with Continuous versus Intermittent Feeding Method in The Intensive Care Unit: A Randomized Controlled Trial

Original Research
  • Vo Thi Hong Nhan, Alison Merrill, Tran Thien Trung,
  • Pages 46-51
  • 21/12/2017
  • 120
  • 1214
  • Free

Background: Enteral nutrition therapy via nasogastric tube can be administered through continuous or intermittent feeding methods for critically ill patients. However, there has not been existing consensus on the superiority of either method for mechanically ventilated patients due to insufficient evidence comparing the effectiveness of the two methods. The present study aimed to compare the impact of continuous versus intermittent feeding methods on gastrointestinal intolerance in mechanically ventilated patients.

Methods: 41 mechanically ventilated patients in the intensive care unit, University Medical Center, Ho Chi Minh City, Vietnam from 3/2017 to 5/2017 were enrolled in a randomized controlled trial. They were randomly and equally assigned to the two study groups and monitored for 4 consecutive days on incidence of gastrointestinal intolerance including high gastric residual volume, abdominal distention, diarrhea, and tube occlusion.

Results: There was statistically significant difference when comparing the gastric residual volumes between two groups with a median at 0.93ml (0.09-1.93) versus 11.61ml (7.61-17.28) (p < 0.001). The mean number of abdominal distention episodes in the continuous group was significantly lower than in the intermittent group (2.8 ± 2.66 versus 8.29 ± 5.1 episodes, respectively, p < 0.001). The diarrhea scores were not significantly different (p < 0.05) and there were no cases of occlusion recorded in the two groups.

Conclusions: Continuous feeding method offered less gastrointestinal intolerance than intermittent feeding method by reducing gastric residual volumes and limiting abdominal distention. The feeding method did not increase the risk of tube obstruction if it was flushed regularly.

Graphical abstract

Pursuing a targeted dream specialty and a research career: Opinions and observations from a fifth-year medical student’s perspective

Letter to Editor
  • Gehad Mohamed Tawfik,
  • Pages 1-4

With our fast-pacing life, numerous learning and scientific sources and information are available and required for medical students to boost their skills since their early life to accommodate with the great knowledge they take. Medical students should re-elaborate what they studied and exploit knowledge clinically. A good doctor is a good observer, so eyes should be kept on while mentor managing patients in order to add more to our medical notions. A seed to become a great future doctor starts by searching for a specialty that fits your personality, to practice it as a volunteer, to gain its skills earlier. So when you graduate, you have more time to gain other learning experience. As long as you practice it, the more chance to become one of its experts. Managing your patient as a relative, not as a bag of money, is very important to be applied. Inability to diagnose a patient is not a shame, so never let a patient go home without referring him to another doctor who has more experience than you. Having a background in other medical specialties will help you recognize common signs of other related medical conditions that could lead you to refer him to right specialty doctor. Joining a research lab will keep you updated with new inventions, drugs, algorithms, and guidelines, which will help you become more acknowledged with medical problems that you were unaware of. Time management is the key to success as a researcher without affecting your daily life activities and study requirements.

Graphical abstract