How Well Do Critically Ill Patients Tolerate Early, Intragastric Enteral Feeding?
Objective: To evaluate whether critically ill patients tolerate early, intragastric enteral feedings. Design: Multicenter, prospective cohort study. Setting: Eight mixed intensive care units at tertiary care hospitals. Patients: We recruited mechanically ventilated critically ill patients expected to remain ventilated >48 hours. We enrolled 120 patients; the feeding protocol was used in 95. Forty percent were women, the mean age was 55.1 ± 18.9 years, and the mean APACHE II score was 21.6 ± 70.6. Interventions: We used a standardized feeding protocol that initiated enteral nutrition (EN) within 48 hours of admission at 25 mL/h and checked gastric residuals every 4 hours. At every 4-hour interval, the feeding rate was increased by 25 mL/h to the target rate, if the residual volume was <200 mL. If the residual volume was >200 mL, the feedings were discontinued temporarily. All patients were fed in the stomach. Motility agents were allowed if the patient had high gastric residuals. Main o
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