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Effect of 2 Enteral Feeding Schedules on Intra-abdominal Pressure in Patients Receiving Mechanical Ventilation: A
Ghada Mahran1, Asmaa Mahgoup1, Emad Zarief Kamel1
1Ghada Mahran and Asmaa Mahgoup are lecturers in the Department of Critical Care Nursing, Faculty of Nursing, Assiut University, Asyut, Egypt. Emad Zarief Kamel is an associate professor in the Department of Anesthesia and Intensive Care, Faculty of Medicine, Assiut University. Muayyad M. Ahmad is a professor in the Clinical Nursing Department, School of Nursing, University of Jordan, Amman, Jordan.
Background:
Elevated intra-abdominal pressure is associated with morbidity in critically ill patients. Enteral feeding is important for these patients but may cause complications.
Objective:
To compare the effects of 2 intermittent feeding schedules on intra-abdominal pressure in patients receiving mechanical ventilation.
Methods:
A single-blinded, prospective, parallel-group, randomized controlled trial was conducted in an intensive care unit in a teaching hospital in Egypt. Fifty adult patients requiring more than 48 hours of mechanical ventilation were enrolled. Patients were randomly sorted into 2 study groups. The intervention group received intermittent enteral feedings 5 times daily at 4-hour intervals. The control group received intermittent enteral feedings 10 times daily at 2-hour intervals. Both groups fasted for 8 hours overnight. Intra-abdominal pressure was measured 7 times: at admission and before and after the first 3 feedings on the third day of the intensive care unit stay.
Results:
One-way repeated-measures analysis of variance showed that mean intra-abdominal pressure was higher in the control group before the first feeding (t = 2.27, P = .03) but was higher in the intervention group after the second feeding (t = 2.51, P = .02) and after the third feeding (t = 2.41, P = .02). Vomiting and diarrhea were not significantly different between the groups. More constipation and abdominal distension occurred in the intervention group than in the control group.
Conclusion:
Intra-abdominal pressure was not significantly affected by feeding interval. However, reducing the time interval between intermittent enteral feedings may minimize the risk for constipation and abdominal distension.
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