Effect of intermittent or continuous feed on muscle wasting in critical illness: A phase II clinical trial
Abstract
BACKGROUND
Acute skeletal muscle wasting in critical illness is associated with excess morbidity and mortality. Continuous feeding may suppress muscle protein synthesis as a result of the muscle-full effect, unlike intermittent feeding which may ameliorate it.
RESEARCH QUESTION
Does intermittent enteral feed decrease muscle wasting compared with continuous feed in critically ill patients?
STUDY DESIGN AND METHODS
In a Phase II interventional single-blinded randomized controlled trial, 121 mechanically-ventilated adult patients with multi-organ failure were recruited following prospective informed consultee assent. They were randomized to the intervention group (intermittent enteral feeding from six four-hourly feeds per 24 hours, n=62) or control group (standard continuous enteral feeding, n=59). The primary outcome was ten-day loss of rectus femoris muscle cross-sectional area determined by ultrasound. Secondary outcomes included nutritional target achievements, plasma amino acid concentrations, glycaemic control and physical function milestones.
RESULTS
Muscle loss was similar between arms (-1.1% (95%CI -6.1, -4.0); p=0.676). More intermittently fed patients received 80% or more of target protein (OR 1.52 (1.16-1.99); p<0.001) and energy (OR 1.59 (1.21-2.08); p=0.001). Plasma branched-chain amino acid concentrations before and after feeds were similar between arms on trial day 1 (71 μM (44-98); p=0.547) and trial day 10 (239 μM (33-444); p=0.178). During the 10-day…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 62 participants or records.
Read the paper
Related studies
- Chaos and quantum thermalization
- The Dalton quantum chemistry program system
- Cord Blood Leptin and Adiponectin as Predictors of Adiposity in Children at 3 Years of Age: A Prospective Cohort Study
- Quantitative metabolomics by H-NMR and LC-MS/MS confirms altered metabolic pathways in diabetes
- Stable adiabatic quantum batteries
- A novel self-lipid antigen targets human T cells against CD1c(+) leukemias
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.