title: Incidence of aspiration and gastrointestinal complications in critically ill patients using continuous versus bolus infusion of enteral nutrition: a pseudo-randomised controlled trial.
abstract: Enteral nutrition (EN) for the critically ill and mechanically ventilated patients can be administered either via the continuous or bolus methods. However, there is insufficient evidence supporting which of these methods may have a lower risk of aspiration and gastrointestinal (GI) complications. This study was conducted in order to identify the incidence of aspiration and GI complications using continuous enteral nutrition (CEN) and bolus enteral nutrition (BEN) in critically ill patients at the Rafik Hariri University Hospital (RHUH), Beirut, Lebanon.
  
  
  METHODS
  A pseudo-randomised controlled trial was conducted on 30 critically ill mechanically ventilated patients receiving EN for more than 72 h. Patients were randomly assigned into the following groups: an experimental group that received CEN and a control group that received BEN. Furthermore, patients' health characteristics data as well as the incidence of aspiration and GI complications (high gastric residual volume "HGRV", vomiting, diarrhoea, and constipation) were subsequently collected.
  
  
  RESULTS
  There were no statistically significant differences between the effects of CEN versus BEN groups on the occurrence of aspiration, HGRV, diarrhoea, or vomiting (P>0.05). However, constipation was significantly greater in patients receiving CEN (10 patients (66.7%)) as compared with those receiving BEN (3 patients (20%)) (P=0.025).
  
  
  CONCLUSIONS
  CEN versus BEN methods did not affect the incidence of aspiration, HGRV, vomiting or diarrhoea. However, the incidence of constipation was significantly greater in patients receiving CEN.
authors: Critical Care Nursing, Beirut Arab University, Lebanon. Electronic address: ibrahimkadamany@hotmail.com.
authors: Ibrahim
authors: I
authors: Kadamani
authors: Associate Professor of Medicine, Beirut Arab University, Lebanon; Head of Pumonary/Critical Care Medicine, Rafik Hariri University Hospital, Beirut, Lebanon. Electronic address: mitani10@hotmail.com.
authors: Mustafa
authors: M
authors: Itani
authors: Professor of Emergency and Critical Care Nursing, Alexandria University, Egypt. Electronic address: emizahran@hotmail.com.
authors: Eman
authors: E
authors: Zahran
authors: Professor of Emergency and Critical Care Nursing, Faculty of Nursing, Alexandria University, Egypt. Electronic address: nadia_taha_4@hotmail.com.
authors: Nadia
authors: N
authors: Taha
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness; D004750:Enteral Nutrition / Q000009:adverse effects*; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial; D053120:Respiratory Aspiration / Q000453:epidemiology* / Q000209:etiology*; D012307:Risk Factors
keywords: Bolus enteral nutrition; Continuous enteral nutrition; Enteral nutrition; Gastrointestinal; High gastric residual volume; Intensive Care Unit