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Intermittent enteral feeding in mechanically ventilated patients. The effect on gastric pH and gastric cultures

C A Spilker1, D R Hinthorn, S K Pingleton

  • 1Department of Medicine, University of Kansas Medical Center Kansas City, USA.

Chest
|July 1, 1996
PubMed
Abstract

Insights

Intermittent enteral feeding (IEF) did not lower gastric pH or clear microbial growth in mechanically ventilated patients. Further studies are needed to assess IEF for reducing gastric colonization and nosocomial pneumonia.

Area of Science:

  • Critical Care Medicine
  • Gastroenterology
  • Infectious Diseases

Background:

  • Enteral feeding is crucial for mechanically ventilated patients.
  • Gastric microbial overgrowth can lead to nosocomial pneumonia.
  • Intermittent enteral feeding (IEF) is an alternative to continuous enteral feeding (CEF).

Purpose of the Study:

  • To evaluate the impact of intermittent enteral feeding (16 h/d) on gastric pH.
  • To assess the effect of IEF on gastric microbial growth in mechanically ventilated patients.

Main Methods:

  • Prospective, case-controlled study in a Medical ICU.
  • Thirteen mechanically ventilated patients initially on continuous enteral feeding (CEF).
  • Gastric pH and cultures were monitored during CEF and after switching to IEF for 5 days.

Main Results:

  • IEF did not significantly alter gastric pH compared to CEF (3.8 +/- 0.6 vs 4.7 +/- 0.5).
  • Gastric microbial growth persisted in 90% of patients after switching to IEF.
  • New Gram-negative rod growth occurred in 38% of patients on IEF, increasing their proportion among isolates.

Conclusions:

  • Preliminary data suggest IEF does not lower gastric pH or eradicate existing microbial growth.
  • Larger controlled studies are required to determine IEF's efficacy in reducing gastric colonization and nosocomial pneumonia.

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