Effects of Continuous Versus Bolus Infusion of Enteral Nutrition on Gastric Residual and Incidence of Aspiration in Critically Ill Patients
Enteral nutrition (EN) is the recommended method of feeding for mechanically ventilated patients which can be administered bolus or continuous. Unfortunately, there is insufficient research evidence supporting a method of them over the other as carrying lower or no risk of complications including; high gastric residual volume (HGRV) and pulmonary aspiration. This study was conducted to identify the effects of using continuous EN (CEN) versus bolus EN (BEN) on gastric residue and occurrence of aspiration in critically ill patients at Rafic Hariri University Hospital (RHUH). An experimental study was conducted at the Intensive Care Unit, RHUH, Beirut on a sample of 30 critically ill ventilated patients aged between 20-80 years, receiving EN for more than 72 hours. Studied sample was assigned randomly into two equal groups; experimental group receiving CEN and control group receiving BEN. A tool was used to collect the required data; part (I) is a general assessment sheet contains patient health characteristics (such as age, sex, height, weight, medical and surgical history, and current medication taken), while part (II) is a patient clinical assessment sheet for neurological parameters (Glasgow coma scale GCS and cough reflex), pulmonary complications (aspiration), and gastrointestinal complications (HGRV, vomiting, diarrhea, and constipation). Study results indicate that there is no significant difference between the effects of CEN and BEN on the occurrence of aspiration, HGRV, and vomiting. Although a marked difference is noted between the two groups concerning the incidence rate of diarrhea related to EN, the relation is not statistically different. On the other hand, a significant difference between the two groups occurs concerning the incidence rate of constipation that it is greater in continuous group than the bolus group. A significant relationship is found between GCS and HGRV occurrence in all study samples in which patients with low GCS have more incidence of HGRV.
Ibrahim Bilal Al Kadamani
Dr. Iman Zahran