Effect of intermittent versus bolus enteral feeding on feeding tolerance among critically ill patients at a tertiary care centre, Puducherry- A Randomized Controlled Trial

This study is a randomized controlled trial on the effect of intermittent versus bolus enteral feeding on feeding tolerance among critically ill patients at JIPMER Puducherry. Patients who meet the inclusion criteria will be divided into two groups through block randomization.

Preparatory phase includes elevating the head of the bed at least 45 degrees to prevent aspiration and preparing articles required for intermittent and bolus feeding. Placement of tube will be confirmed by aspiration and air insufflation with stethoscope.

In intermittent feeding the targeted amount will be given through a feeding bag hung above the bed using a roller controller for one hour. In bolus feeding a syringe will be connected to the nasogastric tube and the feed will be given within 5 to 10 minutes followed by flushing with water.

Feeds will be given six times daily for five days. Gastric residual volume will be checked before every feed using a syringe. If residual volume is more than 50 percent of previous feed or above 250 ml the next feed will be withheld. If volume is below 250 ml it will be discarded and the next feed will be given.

Outcome measure will include gastric residual volume, abdominal distention, vomiting, diarrhea, constipation and achievement of targeted nutrition. Patients will be observed in semi fowlers or elevated position after feeding to reduce regurgitation and aspiration.