CHEST Guidelines-Effect-of-Intermittent-or-Continuous-Feed-on-Muscl

Effect-of-Intermittent-or-Continuous-Feed-on-Muscl

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This Phase 2 clinical trial investigated the effects of intermittent versus continuous enteral feeding on muscle wasting in critically ill patients. Acute muscle wasting is a significant concern in critically ill patients, increasing morbidity and mortality rates. The trial aimed to determine whether intermittent feeding could reduce muscle loss compared to continuous feeding.<br /><br />Conducted across eight UK intensive care units, the study involved 121 mechanically ventilated adults with multi-organ failure. Participants were randomized into two groups: 62 received intermittent enteral feeds (six 4-hourly feeds daily) and 59 received continuous feeds. The primary measurement was the change in the rectus femoris muscle cross-sectional area over 10 days, assessed using ultrasound.<br /><br />The findings showed no significant difference in muscle loss between the two feeding regimens. Muscle cross-sectional area changes were similar in both groups, indicating that intermittent feeding did not mitigate muscle wasting. Despite this, intermittent feeding led to improved achievement of nutritional targets, with more patients receiving 80% or more of their protein and energy needs compared to the continuous feeding group.<br /><br />Intermittent feeding was associated with higher variability in blood glucose levels, although there were no significant differences in hypoglycemic events between the groups. Safety profiles, including gastric tolerance and discharge outcomes, were comparable between the two feeding strategies.<br /><br />The study concluded that while intermittent feeding is safe and feasible, it does not preserve muscle mass in critically ill patients any better than continuous feeding. The trial was registered under ClinicalTrials.gov number NCT02358512. Future research may explore intermittent feeding as a supportive intervention alongside other treatments to enhance muscle protein synthesis and address metabolic challenges in critically ill patients.

Keywords

clinical trial

intermittent feeding

continuous feeding

muscle wasting

critically ill patients

enteral feeding

nutritional targets

blood glucose variability

intensive care units

muscle mass preservation