Background:

Nutritional therapy is fundamental on critically ill patients care, being enteral feeding the preferred mode. The aim of this study was to evaluate enteral feeding tolerance by measuring intraabdominal pressure fluctuations and carbon dioxide production at end expiration (VCO2) comparing two modalities: continuous infusion versus bolus.

Methods:

This study was an open, controlled, clinical trial enrolling 76 patients. Demographic data, severity scales and diagnosis was obtained by ICU admission. Patients were randomized in two groups: I Group, 37 members, received enteral nutritional support in 3 periods with an 8 hour infusion length each one. B Group, 39 members, received enteral feeding in bolus with a max amount of 500 cc given in less than an hour. Six measurements of intraabdominal pressure (IAP) were made daily while giving nutritional support. VCO2 was checked every hour through Draguer Evita XL® ventilator. Residual gastric volume, mechanical ventilation associated pneumonia, mechanical ventilation length, ICU length of stay and mortality were recorded.

Results:

On Group I IAP increased 29% and VCO2 3.8% and on B Group IAP increased 78% and VCO2 43%, both differences were statistically significant (p = 0.001 and p = 0.002 respectively).

Conclusion:

There is a better feeding tolerance giving enteral nutrition support by continuous infusion than bolus, confirming with intraabdominal pressure measurement and carbon dioxide production at end expiration.

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