External metabolic balance studies during nasogastric feeding in serious illnesses requiring intensive care.

BACKGROUND AND OBJECTIVES: Infants hospitalized with bronchiolitis are commenced on nasogastric feeding to maintain hydration. Feeding strategies vary according to physician or institution preference. The current study hypothesized that continuous nasogastric feeding would prolong length of stay (LOS) when compared to bolus feeding. METHODS: A randomized, parallel-group, superiority clinical trial was performed within an Australian children’s hospital throughout 2 bronchiolitis seasons from May 2018 to October 2019. Infants <12 months hospitalized with bronchiolitis and requiring supplemental nasogastric feeding were randomly assigned to continuous or bolus nasogastric regimens. LOS was the primary outcome. Secondary outcome measures included pulmonary aspirations and admissions to intensive care. RESULTS: The intention-to-treat analysis included 189 patients: 98 in the bolus nasogastric feeding group and 91 in the continuous group. There was no significant difference in LOS (median LOS of the bolus group was 54.25 hours [interquartile range 40.25–82] and 56 hours [interquartile range 38–78.75] in the continuous group). A higher proportion of admissions to intensive care was detected in the continuous group (28.57% [26 of 91] of the continuous group vs 11.22% [11 of 98] of the bolus group [P value 0.004]). There were no clinically significant pulmonary aspirations or statistically significant differences in vital signs between the groups within 6 hours of feed initiation. CONCLUSIONS: No significant difference in LOS was found between bolus and continuous nasogastric feeding strategies for infants hospitalized with bronchiolitis. The continuous feeding group had a higher proportion of intensive care admissions, and there were no aspiration events.

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A randomised prospective trial to compare the efficacy of bolus versus continuous nasogastric feeding in paediatric intensive care

Critical Care ◽

10.1186/cc7306 ◽

2009 ◽

Vol 13 (Suppl 1) ◽

pp. P142

Author(s):

P Kamath ◽

J Longden ◽

C Stack ◽

A Mayer

Keyword(s):

Intensive Care ◽

Prospective Trial ◽

Paediatric Intensive Care ◽

Nasogastric Feeding

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Fluid and Nutritional Management Can Significantly Reduce the Mortality of Patients with Eclampsia in Resource Poor Settings

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v27i1.29909 ◽

2016 ◽

Vol 27 (1) ◽

pp. 18-20

Author(s):

Badrunnesa Begum ◽

Nasreen Akhter ◽

Md Kamal Uddin ◽

Md Abdul Aziz ◽

Kashfia Kamal Nova

Keyword(s):

Intensive Care ◽

Fatal Outcome ◽

Care Facility ◽

Nutritional Management ◽

Close Monitoring ◽

College Hospital ◽

Nasogastric Feeding ◽

Medical College ◽

Resource Poor ◽

The Mean

Objective: To observe fluid and nutritional management along with specific management and close clinical monitoring without intensive care management improve the condition of unconcious eclamptic patients in the resource poor setting.Method: Six hundred and nine(609) eclamptic patients were admitted in Mymensingh Medical College Hospital from January to December 2008. Twenty four (24) unconscious eclamptic patients were enrolled for this clinical trial study. These patients were managed in eclampsia ward with fluid therapy of 0.9% sodium chloride, 25% glucose, 5% aminoacids along with hydrocortisone and in some cases nasogastric feeding in addition to other regular medications. They were compared with 26 eclampsia patients treated with normal regular hospital management. A systematic guideline was followed and patients were closely monitored until the outcome.Results: The mean age of 23 years, 18 cases were primi-gravida; 16 had intrapartum, 6 had postpartum and 2 had antepartum eclampsia. The mean number of convulsion before admission was 12. The mean Glasgow Coma Scale (GCS) of these patients during admission was 5, which improved to 10.3 in 24 hours and 14.5 in 36 hours. None of these patients had fatal outcome in compare to observation group where three patients died following complications.Conclusion: Close monitoring with fluid and nutritional management can significantly reduce the mortality of unconscious eclamptic patients in resource poor settings where intensive care facility is limited. Development and adaptation of feasible systematic guideline for the management of unconscious eclamptic patient should be scaled up for the resource poor settings of developing and under developed countries.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(1) : 18-20

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Nutrition support in intensive care units in England: a snapshot of present practice

British Journal Of Nutrition ◽

10.1017/s0007114511001619 ◽

2011 ◽

Vol 106 (8) ◽

pp. 1240-1244 ◽

Cited By ~ 12

Author(s):

Mahtab N. Sharifi ◽

Anna Walton ◽

Gayatri Chakrabarty ◽

Tony Rahman ◽

Penny Neild ◽

...

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Care Management ◽

General Information ◽

Nutrition Support ◽

Nasogastric Feeding ◽

High Dependency ◽

Phone Survey ◽

Nasojejunal Feeding ◽

The Uk

Nutrition support is an important part of care management in critically ill patients, not only to prevent and treat malnutrition but also it has a significant impact on recovery from illness and overall outcome. There is little information available about present nutritional support practice for patients in intensive care units (ICU) in the UK. This survey was designed to evaluate the present nutrition support practice in ICU and high dependency units (HDU) in England. Data were gathered by a 72 h phone survey from 245 ICU and HDU in 196 hospitals in England. A questionnaire was completed over the telephone, including general information, nutrition support and teams involved in the nutrition management in the ICU. Of 1286 total patients in the ICU, 703 (54·6 %) were receiving nasogastric feeding, two (1·5 %) were receiving feeding via a percutaneous endoscopically placed gastrostomy tube and two (1·5 %) were receiving nasojejunal feeding. One hundred and forty-seven (11·4 %) patients were on parenteral feeding during the study period. A nutrition support team was not available in 158 (83·1 %) ICU and there was no dietitian or specialist nutrition nurse to cover ICU in nine (4·7 %) hospitals. In conclusion, the present survey reported an increased trend in usage of enteral feeding in ICU in England, and a reduction in the use of parenteral nutrition compared with previous surveys. However, we are still far from integrating nutrition into care management in the ICU.

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