Maia Fae Aquino
Ospital ng Makati, Philippines
Title: A randomized controlled trial on the effects of intermittent gravity drip vs. bolus enteral feeding on the incidence of hospital-acquired pneumonia among intensive care patients
Biography
Biography: Maia Fae Aquino
Abstract
Introduction & Aim: Hospital acquired pneumonia is a frequent complication of patients on enteral feeding. Bolus feeding is currently practice in our institution however its aspiration risk is not yet established. Intermittent gravity feeding is widely used however its eff ectiveness in preventing pneumonia is not yet proven. Trials have shown conflicting results on which feeding method has a lower risk for pneumonia.
Method: We performed a randomized study to examine the effectiveness of intermittent gravity drip feeding as a strategy in reducing the incidence of pneumonia. We included patients requiring nasogastric feeding within 24 hours from admission. We randomly assigned patients using fish-bowl technique to either intermittent gravity drip feeding or bolus feeding. The primary outcome was development of hospital acquired pneumonia. The secondary outcome was length of hospital stay and mortality.
Results: 106 were randomized into intermittent group and 104 into the bolus group. Th e baseline characteristics were similar at the start of the study. The primary outcome occurred in 55 of 104 patients (53%) in bolus group and 21 of 106 patients (20%) in the intermittent group (RR=0.37). Mortality occurred in 42 of 104 patients (41%) in bolus group and 26 of 106 patients (25%) in the intermittent group (RR=0.60). Th e average hospital stay for the bolus group was 17±11 days compared to intermittent group with 13±10 days.
Conclusion: Patients receiving intermittent gravity drip feeding had a lower rate of hospital-acquired pneumonia and mortality compared to those receiving bolus feeding. Th ere was no signifi cant diff erence on the length of hospital stay between the two methods of feeding.