Gastric feeding in critically ill children: A randomized controlled trial

BACKGROUND Provision of enteral nutrition via the gastric route is a common nursing procedure in pediatric intensive care units. Little research, however has focused on children tolerance of different of gastric feeding regimens. OBJECTIVES To examine the relationship between 2 gastric feeding regimens, continuous and intermittent, and children tolerance as measured by the number of stools and prevalences of diarrhea and vomiting. METHODS A randomized controlled trial was conducted in an Australian pediatric intensive care unit; 45 children were randomly assigned to either the continuous or the intermittent gastric feeding groups. Participants remained in the assigned feeding group for the duration of the study, and values of variables used to monitor patients' tolerance were recorded. RESULTS Both feeding groups were similar with respect to Pediatric Index Mortality score, age, weight, sex, diagnosis, and use of pharmacological agents known to affect the gastrointestinal tract. Additionally the 2 groups did not differ in study duration or the daily volume of administered enteral formula per kilogram of body weight. The number of stools per day and the prevalences of diarrhea and vomiting did not differ significantly between the 2 groups. DISCUSSION Continuous and intermittent gastric feeding regimens have similar outcomes with respect to the number of stools per day and the prevalence of diarrhea and vomiting in pediatric intensive care patients. Further gastric feeding studies and the development of enteral feeding guidelines for critically ill children are needed.