CHEST Guidelines-Effect-of-Intermittent-or-Continuous-Feed-on-Muscl (1)

Effect-of-Intermittent-or-Continuous-Feed-on-Muscl (1)

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The study titled "Effect of Intermittent or Continuous Feed on Muscle Wasting in Critical Illness: A Phase 2 Clinical Trial" investigates the impact of feeding methods on muscle wasting in critically ill patients. It specifically compares intermittent enteral feeding to continuous feeding in 121 mechanically ventilated adult patients with multiorgan failure. The trial was conducted as a single-blinded randomized controlled study, aiming to determine whether intermittent feeding could decrease muscle wasting over 10 days, as measured by the cross-sectional area of the rectus femoris muscle.<br /><br />The findings showed no significant difference in muscle loss between the two feeding methods, with intermittent feeding not markedly preserving muscle mass compared to continuous feeding. However, patients in the intermittent feeding group more frequently reached nutritional protein and energy targets. Plasma concentrations of branched-chain amino acids and glucose control metrics were similar between the groups, although glucose variability was higher with intermittent feeding.<br /><br />Despite these outcomes, intermittent feeding was shown to be a feasible and safe intervention. The study concluded that while intermittent feeding alone does not prevent muscle wasting in critically ill patients, it does optimally support nutritional target achievement. Future trials may explore intermittent feeding combined with other interventions to enhance muscle protein synthesis or functional recovery.<br /><br />The trial, registered under ClinicalTrials.gov (NCT02358512), was conducted across multiple centers in the UK and underwent ethical approval. It highlights the need for continued exploration of effective nutritional strategies in critical care to prevent muscle wasting and enhance recovery outcomes.

Keywords

intermittent feeding

continuous feeding

muscle wasting

critical illness

clinical trial

mechanically ventilated

nutritional targets

branched-chain amino acids

glucose control

multicenter study