THE EFFECT OF TWO METHODS OF INTERMITTENT ENTERAL FEEDING ON CRITICALLY ILL PATIENTS

Abstract

Malnutrition is a major health problem of many critically ill patients, due to the increased catabolic state often associated with acute illness and frequent presence of prior chronic wasting conditions. Nutritional support is thus an important part of patients' management. Over the years, enteral nutrition has gained considerable popularity due to its favorable effects. Enteral nutrition is characterized by lower cost and fewer complications when compared to parenteral nutrition. Nevertheless enteral feeding 1s not complications free. Complications of enteral feeding are related to multiple factors e.g. critical illness, rate and volume of formula, type of medication, and patient's position during and after feeding. Complications related to enteral feeding are classified into mechanical, gastrointestinal, and metabolic complications. The aim of this study was to compare the effect of bolus versus slow gravity drip on critically ill patients. Mechanical complications include pulmonary aspiration, tube occlusion, and tube malposition. While gastrointestinal include diarrhea, delayed gastric emptying, constipation, distension, vomiting, and gastric pH. Furthermore, metabolic complications include fluid balance disturbances and electrolyte abnormalities. The methods used to deliver enteral feeding were bolus and slow gravity drip. Bolus feeding involves the administration of 300 - 400 ml of formula through a syringe over a period of 15 minutes every 3 -4 hours. This is not usually tolerated by the critically ill patients .