How Well Do Critically Ill Patients Tolerate Early, Intragastric Enteral Feeding?

Objective: To evaluate whether critically ill patients tolerate early, intragastric enteral feedings. Design: Multicenter, prospective cohort study. Setting: Eight mixed intensive care units at tertiary care hospitals.

Patients: We recruited mechanically ventilated critically ill patients expected to remain ventilated >48 hours. We enrolled 120 patients; the feeding protocol was used in 95. Forty percent were women, the mean age was 55.1 ± 18.9 years, and the mean APACHE II score was 21.6 ± 70.6.

Interventions: We used a standardized feeding protocol that initiated enteral nutrition (EN) within 48 hours of admission at 25 mL/h and checked gastric residuals every 4 hours. At every 4-hour interval, the feeding rate was increased by 25 mL/h to the target rate, if the residual volume was 200 mL, the feedings were discontinued temporarily. All patients were fed in the stomach.

Motility agents were allowed if the patient had high gastric residuals. Main ... more.

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