Enteral nutrition in critical patients: should the administration be continuous or intermittent?
Enteral nutrition in critical patients: should the administration be continuous or intermittent?
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DOI：
10.3305/nh.2014.29.3.7169
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发表时间：
2014-03-01
期刊：
影响因子：
--
通讯作者：
Caporossi, Cervantes
中科院分区：
文献类型：
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作者：
Maeve Tavares de Araujo, Viviane;César Gomes, Paulo;Caporossi, Cervantes
肠内营养治疗(ENT)是危重病患者治疗的重要组成部分，对危重病患者的临床疗效有重要影响。它可以使用输液泵连续或间歇地给药。关于这些技术中哪一种的效果最好，涉及到许多因素，如恶心、腹泻，特别是饮食量与程序卡路里与有效供应给危重患者的卡路里的比例之间的关系。目的：比较持续或间断输入肠内营养的形式，以估计每天所需的热量水平作为主要结果。方法：在重症监护病房对41例患者进行前瞻性随机临床观察，分为两组：间断给药(18小时，夜间停顿6小时)和连续(24小时连续)。在这项研究中测量的次要结果变量是肠道排空、扩张、呕吐，主要结果变量是输液量和估计的热量需求与供应比率之间的关系。结果：大多数患者在5天的研究中接受了超过60%的肠内饮食(p=1.0)，在提供热量需求方面没有差异。两组患者在呕吐、腹胀、腹泻等方面的差异无统计学意义。结论：在本研究变量的比较中，连续性肠内营养和间歇性肠内营养的给药方式是相似的。
Enteral nutrition therapy (ENT) is an essential part in the management of critically ill patients, having a significant impact on these patients' clinical results. It can he administered on a continuous or intermittent basis using an infusion pump. There is a discussion on which of these techniques has the best performance, involving a number of factors such as nausea, diarrhea, and particularly the relationship between diet volume and the ratio of programed calories to calories effectively supplied to the critical patients.Objectives: To compare the forms of continuous or intermittent infusion of enteral nutrition, using as primary outcome the level of estimated caloric needs daily supplied.Methods: Observational prospective randomized clinical study carried out in an intensive care unit on 41 patients divided into two groups, of intermittent (ENT during 18 hours with a 6-hour nocturnal pause), or continuous (ENT during 24 hours continuously) administration. The secondary outcome variables measured in this study were bowel evacuation, distension, emesis, with the primary outcome variable being the relationship between infusion volume and the estimated-to-supplied ratio of caloric needs. The rejection index of the null hypothesis was established at 5% for all the tests.Results: Most of the patients received more than 60% infusion of enteral diet over the 5 days of study (p = 1.0), with no difference regarding the provision of caloric needs. No statistically significant difference between groups was found in the variables vomiting, abdominal distension or diarrhea.Conclusion: The administration modalities of continuous or intermittent enteral nutrition are similar in which regards the comparison of the variables included in this study.