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Is bolus or continuous enteral feeding better in critically ill children: An evidence-based review
Hayley Littler1, Lyvonne N Tume2
1Paediatric Intensive Care Unit, Alder Hey Children's Hospital, Liverpool, UK.
Insights
Enteral nutrition for mechanically ventilated children in the paediatric intensive care unit (PICU) can be given intermittently or continuously. Evidence suggests bolus feeding may help children reach nutritional goals faster, but more research is needed.
Area of Science:
- Pediatric Intensive Care
- Clinical Nutrition
- Mechanical Ventilation
Background:
- Inadequate nutrition increases morbidity and mortality in mechanically ventilated children in the paediatric intensive care unit (PICU).
- Enteral feeding practices vary in UK PICUs, with options including gravity bolus (intermittent) and continuous pump feeding.
- Optimal enteral feeding strategies are crucial for improving outcomes in critically ill children.
Conclusions:
- Current evidence comparing bolus and continuous enteral feeding in mechanically ventilated children is conflicting.
- While bolus feeding might offer advantages in meeting nutritional goals, further research is essential.
- More studies are needed to establish whether feeding method impacts critical patient outcomes in the PICU.
Abstract:
Inadequate nutrition can lead to increased morbidity and mortality for mechanically ventilated children in the paediatric intensive care unit (PICU). Enteral feeding can either be delivered by gravity bolus (intermittent) feeding or continuously via a pump and in UK PICUs variable practice exists. This evidence-based review therefore aimed to examine the evidence surrounding the two feeding methods for ventilated children, to determine whether one provides better enteral nutrition. Four papers were included, three randomized controlled trials and a systematic review, which provide conflicting evidence. There is some suggestion that bolus feeding may be superior in medical children on PICU to achieve their energy and protein goals faster, however, the clinical significance of the results is questionable and further research is needed to identify whether one method of feeding can impact on patient outcomes.
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