Intermittent Feeding Methods Research Articles

Asuhan Keperawatan Kritis Pada Pasien Chronic Kidney Disease CKD Dengan Intervensi Inovasi Memberikan Nutrisi Enteral Menggunakan Metode Intermiten Feeding Untuk Mengurangi Produksi Residu Lambung di Ruang ICU RSU Kabupaten Tengerang

Background: Critical care developed starting from a need for patients experiencing life-threatening illnesses that could be better met if the patient was cared for in a different room. Chronic Kidney Disease (CKD) is defined as a decrease in kidney function characterized by a glomerular filtration rate (GFR) < 60 ml/min/1.73 m2 that occurs for more than 3 months (Mahesvara, 2020). Nutrition is an important part of the management of critical patients such as those suffering from advanced Chronic Kidney Disease (CKD). Providing nutrition to critical patients is to encourage the healing process. Inaccuracy in administering enteral nutrition can cause complications such as high gastric residual volume, gastric retention, diarrhea, nausea and vomiting. High gastric residues during enteral nutrition increase the risk of pulmonary aspiration which is the most severe complication of enteral nutrition. Intermittent feeding is one method of providing enteral nutrition to prevent these complications. The aim of this research is to provide comprehensive nursing care for patients with Chronic Kidney Disease (CKD). This writing method uses patient intervention and observation carried out for three days, to determine the patient's condition and provide appropriate nursing care which is then documented. Results: Based on the results of the intervention and monitoring carried out, it can be concluded that there are differences in the conditions of gastric residue production before and after the enteral feeding intervention using the intermittent feeding method. With the result criteria of maintaining nutritious food intake increases. Conclusion: In critical patients there is a slowdown in gastric emptying and intestinal motility so that if enteral nutrition is given quickly into the stomach there will be an increase in gastric residue. Nursing action as an evidence base that can be given is in the form of providing enteral nutrition using the intermittent feeding method so that the stomach can be better prepared to receive nutrition because it is given gradually, a stomach that is not completely filled will be able to digest food better and the stomach will empty more quickly, thereby reducing the risk of aspiration.

A Comparison of Slow Infusion Intermittent Feeding versus Gravity Feeding in Preterm Infants: A Randomized Controlled Trial.

The transition to full enteral feeding is important for ensuring adequate growth in preterm infants. The aim of this study was to investigate the effects of two different intermittent feeding methods on the transition to full enteral feeding in preterm infants. A prospective, randomized controlled study was conducted in a neonatology and perinatology center. Preterm infants with a gestational age between 24 + 0/7 and 31 + 6/7 were included in this study. They were divided into two groups: the SIF (slow infusion feeding) group and the IBF (intermittent bolus feeding) group. In the SIF group, feed volumes were administered over one hour using an infusion pump through an orogastric tube, with feeding occurring every three hours. The IBF group received enteral feeding using a gravity-based technique with a syringe through an orogastric tube, completed within 10 to 30 min. The primary outcome was the achievement of full enteral feeding and the occurrence of feeding intolerance. A total of 103 infants were enrolled in the study (50 in SIF and 53 in IBF). The time to achieve full enteral feeding did not differ significantly between the two groups (p = 0.20). The SIF group had significantly fewer occurrences in which gastric residual volume exceeded 50% (p = 0.01). Moreover, the SIF group had a significantly shorter duration of non-per-oral (NPO) status than the IBF group (p = 0.03). It is our contention that the use of the SIF method as an alternative feeding method is appropriate for infants with feeding intolerance and those at high risk of feeding intolerance.

Effects of feeding methods on ecological soil wastewater infiltration systems for sewage treatment

Intermittent feeding method and continuous feeding method were adopted in two experimental form ecological soil wastewater infiltration systems (ESWISs), respectively. The results showed that COD, NH4 + and TN removal efficiencies were enhanced from 81.8%, 70.5% and 45.8% in continuous feeding ESWIS to 90.0%, 88.5% and 72.7% in intermittent feeding ESWIS. The same TP removal efficiency was achieved in two feeding mehtods. Matrix oxidation reduction potential (ORP) was enhanced through the intermittent feeding ESWIS, especially above 60 cm depth of the matrix, which encouraged nitrification. The metabolic activity and reproduction of microbes were improved by intermittent feeding method, such as actinomyces, bacteria, nitrifying bacteria, fungus. Meanwhile, denitrifying bacteria and nitrate reductase (NR), nitrite reductase (NIR) activities were also increased. PCR-DGGE analysis confirmed that intermittent feeding method improved bacterial diversity. These results suggest that intermittent feeding method is viable to heighten the performance of ESWISs in sewage treatment.

The Incidence and Characteristics of Gastrointestinal Intolerance on Mechanically Ventilated Patients with Continuous versus Intermittent Feeding Method in The Intensive Care Unit: A Randomized Controlled Trial

Enteral nutrition therapy via nasogastric tube can be administered through continuous or intermittent feeding methods for critically ill patients. However, there has not been existing consensus on the superiority of either method for mechanically ventilated patients due to insufficient evidence comparing the effectiveness of the two methods. The present study aimed to compare the impact of continuous versus intermittent feeding methods on gastrointestinal intolerance in mechanically ventilated patients. 41 mechanically ventilated patients in the intensive care unit, University Medical Center, Ho Chi Minh City, Vietnam from 3/2017 to 5/2017 were enrolled in a randomized controlled trial. They were randomly and equally assigned to the two study groups and monitored for 4 consecutive days on incidence of gastrointestinal intolerance including high gastric residual volume, abdominal distention, diarrhea, and tube occlusion. There was statistically significant difference when comparing the gastric residual volumes between two groups with a median at 0.93ml (0.09-1.93) versus 11.61ml (7.61-17.28) (p < 0.001). The mean number of abdominal distention episodes in the continuous group was significantly lower than in the intermittent group (2.8 ± 2.66 versus 8.29 ± 5.1 episodes, respectively, p < 0.001). The diarrhea scores were not significantly different (p < 0.05) and there were no cases of occlusion recorded in the two groups. Continuous feeding method offered less gastrointestinal intolerance than intermittent feeding method by reducing gastric residual volumes and limiting abdominal distention. The feeding method did not increase the risk of tube obstruction if it was flushed regularly.

Comparison of Intermittent and Bolus Enteral Feeding Methods on Enteral Feeding Intolerance of Patients with Sepsis: A Triple-blind Controlled Trial in Intensive Care Units.

BACKGROUND Recent trials have shown controversial results on which enteral feeding methods has a lower risk of enteral feeding intolerance. Therefore, we aimed to compare two methods of bolus and intermittent feeding on enteral feeding intolerance of patients with sepsis. METHODS This triple-blind randomized controlled trial was conducted on 60 patients with sepsis, who were fed through tubes for at least 3 days. The patients were randomly assigned into bolus feeding, intermittent feeding, and control groups. Enteral feeding intolerance of all patients was recorded in 3 consecutive days by a researcher-made checklist including the data on gastric residual volume, vomiting, diarrhea, constipation, and abdominal distension. RESULTS There were no significant differences between the three studied groups in none of the intervention days pertaining to constipation, diarrhea, vomiting, abdominal distention, and gastric residual volume (p > 0.05). Also, no statistically significant difference was found between all variables in the three studied groups during the 3 days (p > 0.05). CONCLUSION As enteral feeding intolerance of patients with sepsis was similar in both bolus and intermittent feeding methods, it can be concluded that bolus method can still be used as a standard method to decrease the risk of enteral feeding intolerance if it is used properly

Online, efficient and precision laser profiling of bronze-bonded diamond grinding wheels based on a single-layer deep-cutting intermittent feeding method

In this study, an online, efficient and precision laser profiling approach that is based on a single-layer deep-cutting intermittent feeding method is described. The effects of the laser cutting depth and the track-overlap ratio of the laser cutting on the efficiency, precision and quality of laser profiling were investigated. Experiments on the online profiling of bronze-bonded diamond grinding wheels were performed using a pulsed fiber laser. The results demonstrate that an increase in the laser cutting depth caused an increase in the material removal efficiency during the laser profiling process. However, the maximum laser profiling efficiency was only achieved when the laser cutting depth was equivalent to the initial surface contour error of the grinding wheel. In addition, the selection of relatively high track-overlap ratios of laser cutting for the profiling of grinding wheels was beneficial with respect to the increase in the precision of laser profiling, whereas the efficiency and quality of the laser profiling were not affected by the change in the track-overlap ratio. After optimized process parameters were employed for online laser profiling, the circular run-out error and the parallelism error of the grinding wheel surface decreased from 83.1μm and 324.6μm to 11.3μm and 3.5μm, respectively. The surface contour precision of the grinding wheel significantly improved. The highest surface contour precision for grinding wheels of the same type that can be theoretically achieved after laser profiling is completely dependent on the peak power density of the laser. The higher the laser peak power density is, the higher the surface contour precision of the grinding wheel after profiling.

Near‐Infrared Spectroscopy Measurements of Splanchnic Tissue Oxygenation During Continuous Versus Intermittent Feeding Method in Preterm Infants

The aim of the present study was to compare the effects of continuous and intermittent bolus milk feeding on splanchnic regional oxygenation (rSO₂S) in small-for-gestational age (SGA) and appropriate-for-gestational age (AGA) preterm infants. Infants with gestational age <32 weeks were prospectively studied by near-infrared spectroscopy. Each infant was given a milk bolus in ~10 minutes (intermittent feeding) followed after 3 hours by a 3-hour continuous feeding. rO₂S and splanchnic fractional oxygen extraction ratio (FOES [S = splanchnic]) were recorded 30 minutes before (T₀) and 30 minutes after the beginning of bolus feeding (T₁), 30 minutes before (T₂), at the end (T₃), and 30 minutes after the continuous feeding period (T₄). rSO2S increased at T₁ in both AGA and SGA groups, whereas FOES did not vary during the study period. Moreover, we found that rSO2S was higher and FOES was lower at T₁ and T₃ in the AGA than in the SGA group. Bolus milk feeding increases splanchnic oxygenation in both AGA and SGA infants, whereas continuous feeding does not. Splanchnic oxygenation is higher in AGA than in SGA infants both during bolus and continuous feeding. Continuous enteral feeding could help to limit the risk of hypoxic-ischemic gut damage in preterm infants in critical condition, especially in AGA infants.

Comparison of Continuous and Intermittent Feeding Methods in Low Birth Weight Infants

Objective About 1 % of infants are of very low birth weight. However, they comprise about 50% of infant mortality. We compare the effects of continuous versus intermittent feeding on physical growth, gastrointestinal tolerance and macronutrient retention in low birth weight infants (Methods A prospective randomized trial clinical trial was performed from 2004-2005. Very low birth weight neonates (n=73) stratified by birth weight were randomly assigned to either the continuous (24- hour) pump group (n=37) or intermittent (every 2 hours) nasogastric tube feeding group (n=35). Weight was measured and recorded on the 3rd , 7th , 10th ,13th ,16th ,19th ,22nd day and at discharge. Data was analyzed via SPSS software, t-student and chi-square tests. Results There were no significant differences in birth weight, gestational age, first feeding age and weight at beginning study. Of the 73 neonates, 61 neonates were discharged from hospital, 11 neonates died and one of them dropped out of the study because of early discharge. There were no significant differences in weight gaining, feeding tolerance, discharge weight (p=0.33) or severity of respiratory distress between the groups. Conclusion This study showed that there were no differences in infant growth relative to the type of feeding.

A prospective randomized trial comparing continuous versus intermittent feeding methods in very low birth weight neonates

OBJECTIVE: To compare the effects of continuous versus intermittent feedings on physical growth, gastrointestinal tolerance, and macronutrient retention in very low birth weight infants (<1500 gm). STUDY DESIGN: Very low birth weight neonates stratified by birth weight were randomly assigned to either continuous (24-hour) or intermittent (every 3 hours) nasogastric feedings. Feedings with half-strength Similac Special Care formula were initiated between day 2 and 3 and were advanced isoenergetically to goal. Daily weights, volume/caloric intakes, weekly anthropometric and dynamic skin-fold thickness measurements, and data on feeding milestones and clinical complications were collected. Nitrogen, carbohydrate, and fat balance studies were performed on a subset of male subjects. RESULTS: Eighty-two neonates with birth weights between 750 and 1500 gm who were born between 27 and 34 weeks of gestation were randomly assigned to continuous (n = 42) and intermittent (n = 40) feeding groups. There were no significant differences in baseline demographics and severity of respiratory distress between groups. There were no significant differences in days to regain birth weight, days to full enteral feedings, days to discharge, and discharge anthropometric measurements between continuously fed and intermittently fed infants, both when evaluated together and according to 250 gm weight intervals. Retention rates of nitrogen, fat, total carbohydrate, and lactose were comparable in the continuously fed (n = 17) and intermittently fed (n = 13) male neonates. Very low birth weight neonates who were fed continuously did not have feeding-related complications. CONCLUSION: Very low birth weight infants achieve similar growth and macronutrient retention rates and have comparable lengths of hospital stay whether they are fed with continuous or intermittent feedings. (J P EDIATR 1996;128:748-52)