Continuous tube better than intermittent feeding for haemorrhagic stroke patients

Although continuous tube feeding is effective in enhancing the tolerance of enteral nutrition, a recent study has found not enough evidence supporting its advantage in calorie intake in patients with haemorrhagic stroke.

The investigators sought to examine the effects of intermittent as opposed to continuous tube feeding on its intolerance performance and efficiency of calorie intake in a convenience sample selected from January 2018 to January 2019 in the Neurosurgery Department of West China Hospital, Sichuan Province. Participants were randomized to receive either intermittent or continuous tube feeding, fed four times or 24 hours a day using electric feeding pump, respectively. The incidences of the intolerance and calorie intake were then recorded and analysed.

Seventy patients participated in this randomized controlled trial: 40 in the intermittent group and 38 in the continuous tube feeding group. Participants in the latter had significantly lower incidence of diarrhoea compared with those in the former (7.9 percent vs 37.5 percent; p=0.002).

The continuous tube feeding group also showed significantly lower total intolerance than the intermittent group (63.2 percent vs 85 percent; p=0.027), but no significant between-group difference was found in calorie intake during the first 3 days (2595.4±394.5 vs 2317.8±645.1 kcal; p=0.099). There was also no significant difference seen in total calorie intake between the two groups (6265.6±1261.3 vs 6429.4±1452.4 kcal; p=0.597).

An earlier study reporting the pros and cons of continuous and intermittent feeding reported that the latter had not been shown to increase glucose variability or gastrointestinal intolerance, making the former the preferred method. [Curr Opin Crit Care 2018;24:256-261]