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Continuous or intermittent feeding: pros and cons

Bear, Danielle E.a,b,c,d,e,*; Hart, Nicholasc,d,e; Puthucheary, Zudine,f,g,*

Current Opinion in Critical Care: August 2018 - Volume 24 - Issue 4 - p 256–261
doi: 10.1097/MCC.0000000000000513
METABOLIC SUPPORT: Edited by Arthur R.H. van Zanten
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Purpose of review There has been a recent shift in the focus of providing nutrition support to critically ill adults towards enhancing recovery and promoting survivorship. With this has come an evaluation of our current approaches to nutrition support, which includes whether continuous feeding is optimal, particularly for reducing muscle wasting, but also for managing blood glucose levels and feeding intolerance and at the organizational level. This review will discuss the pros and cons of using intermittent and continuous feeding relating to several aspects of the management of critically ill adults.

Recent findings Few studies have investigated the effect of intermittent feeding over continuous feeding. Overall, intermittent feeding has not been shown to increase glucose variability or gastrointestinal intolerance, two of the reasons continuous feeding is the preferred method. A current study investigating the effect of intermittent vs. continuous feeding is awaited to provide insight into the effect of muscle wasting.

Summary Although there are limited studies investigating the safety and efficacy of an intermittent rather than continuous feeding regimen in critically ill adults, there are several theoretical advantages. Further studies should investigate these and in the meantime, feeding regimens should be devised based on individual patient factors.

aDepartment of Nutrition and Dietetics

bDepartment of Critical Care

cLane Fox Clinical Respiratory Physiology Research Unit, Guy's and St Thomas’ NHS Foundation Trust

dCentre for Human and Applied Physiological Sciences, King's College London

eLane Fox Respiratory Unit, Guy's and St Thomas’ NHS Foundation Trust

fDepartment of Medicine, Centre for Human Health and Performance, University College London

gDepartment of Intensive Care, The Royal Free London NHS Foundation Trust, London, UK

Correspondence to Danielle E. Bear, St Thomas’ Hospital, Westminster Bridge Rd, London SE1 7EH, UK. Tel: +44 207 188 5642; e-mail: Danielle.Bear@gstt.nhs.uk

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