Comparison of Protocol-Based Continuous and Intermittent Tube Feeding in Mechanically Ventilated Critically Ill...

Area of Science:

• Pediatric critical care medicine
• Clinical nutrition
• Gastroenterology

Background:

• Optimizing nutritional delivery is crucial for critically ill children.
• Enteral nutrition is preferred, but delivery methods vary.
• Continuous tube feeding (CTF) and intermittent tube feeding (ITF) are common methods.

Purpose of the Study:

• To compare the efficacy of CTF versus ITF in critically ill children.
• To determine the time to reach target calorie and protein intake.
• To evaluate secondary outcomes including feed intolerance and mortality.

Main Methods:

• Randomized trial in a Pediatric Intensive Care Unit (PICU).
• Children randomized to CTF or ITF groups.
• Primary outcome: time to reach 70% WHO target calories and 1.5 g/kg ASPEN target protein.

Main Results:

• No significant difference in time to reach target calories (p=0.69) or protein (p=0.55) between CTF and ITF.
• Median times for target calories: 1.7 days (CTF) vs. 1.8 days (ITF).
• Other outcomes, including mortality and feed intolerance, were not significantly different.

Conclusions:

• CTF and ITF demonstrate comparable effectiveness in achieving nutritional targets in critically ill children.
• The choice of feeding method may not impact the speed of nutritional delivery.
• Further research could explore patient-centered outcomes.