Intermittent feeding in intensive care - the theory and practice
Language English Country Czech Republic Media print
Document type Journal Article, Review
PubMed
33910339
PII: 126439
Knihovny.cz E-resources
- Keywords
- Protein synthesis, enteral nutrition, intensive care, intermittent feeding, muscle atrophy,
- MeSH
- Enteral Nutrition * MeSH
- Intensive Care Units MeSH
- Critical Illness MeSH
- Humans MeSH
- Critical Care * MeSH
- Observational Studies as Topic MeSH
- Retrospective Studies MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
INTRODUCTION: Nutrition therapy becomes one of the fundamental conditions of a successful outcome in malnourished patients and in critically ill patients. The administration of enteral feeding in critically ill patients is mostly performed by continuous or cyclic feeding. On the contrary, the potential benefits of intermittent feeding include increased muscle protein synthesis. This review outlines the theory of a possible anabolic effect of intermittent feeding. The authors describe their experience with implementation of this method of administration in the intensive care unit including the follow-up of possible complications and adverse effects. METHODS: Six patients with intermittent feeding were followed retrospectively during the study period. In addition to demographic data, potential complications related to intermittent enteral feeding (aspiration pneumonia, increased gastric residual volume, abdominal discomfort, osmotic diarrhoea) were evaluated. RESULTS: The average time of intermittent feeding was 8 days. The sum of intermittent feeding days was 63. No aspiration followed by pneumonia was detected during this period. The gastric residual volume did not increase, either. Abdominal discomfort and osmotic diarrhoea were not observed in any patient. CONCLUSION: Although continuous and cyclic enteral feeding in critically ill patients remains the standard and the most common practice, it is considered as a non-physiological method with possible negative consequences for the patient. On the other hand, intermittent feeding is theoretically associated with respecting of the circadian rhythm and with activation of autophagy. Intermittent feeding increases muscle protein synthesis and supports the release of fatty acids. As shown by our observational study, intermittent administration of enteral nutrition in intensive care can be implemented without any adverse effects; however, it is more time consuming for the nurses.