Intermittent enteral nutrition shortens the time to achieve
nutritional goals in critically ill patients

J 2025

Intermittent enteral nutrition shortens the time to achieve nutritional goals in critically ill patients

HRDÝ, Ondřej, Kamil VRBICA, Jaroslav DUBA, Martin SLEZÁK, Eva STRAŽEVSKÁ et. al.

Základní údaje

Originální název

Intermittent enteral nutrition shortens the time to achieve nutritional goals in critically ill patients

Autoři

HRDÝ, Ondřej (203 Česká republika, domácí), Kamil VRBICA (203 Česká republika, domácí), Jaroslav DUBA (203 Česká republika), Martin SLEZÁK (203 Česká republika, domácí), Eva STRAŽEVSKÁ (203 Česká republika, domácí), Viktor AGALAREV (703 Slovensko, domácí), Miloš DUBA (203 Česká republika, domácí), Radka ŠTĚPÁNOVÁ (203 Česká republika, domácí), Adam SVOBODNÍK (203 Česká republika, domácí) a Roman GÁL (203 Česká republika, domácí)

Vydání

Scientific Reports, BERLIN, NATURE PORTFOLIO, 2025, 2045-2322

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30221 Critical care medicine and Emergency medicine

Stát vydavatele

Německo

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 3.800 v roce 2023

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1038/s41598-025-86633-4

UT WoS

001402005200009

EID Scopus

999

Klíčová slova anglicky

Critical care; Enteral nutrition; Intensive care unit; Gastric residual volume; Ventilator-associated pneumonia; Diarrhea

Štítky

14110224, 14110233, 14110516

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 3. 2. 2025 13:51, Mgr. Tereza Miškechová

Anotace

V originále

Nutritional support is associated with improved clinical outcomes in critically ill patients; however, loss of muscle mass during critical illness leads to weakness, delayed return to work, and increased healthcare consumption. Animal data have suggested that intermittent feeding decreases protein catabolism. This study was aimed at determining whether the mode of enteral nutrition administration might lead to differences in meeting nutritional goals, tolerance, and complications. A prospective, randomized, single-center clinical trial was conducted in four intensive care units in the Czech Republic. Critically ill adult patients with high nutritional risk were randomized to continuous or intermittent enteral nutrition administration through a tolerance-driven protocol. The primary outcome was the time to reach the energetic target. Secondary outcomes included assessment of tolerance (high gastric residual volume, vomitus, and diarrhea), complications (aspiration or ventilator-associated pneumonia), and 28-day mortality. A total of 300 patients were randomized, and 294 were analyzed: 148 in the continuous arm and 146 in the intermittent arm. Regarding the primary outcome, log-rank test indicated that the intermittent group, compared with continuous group, had a statistically significantly shorter time (p = 0.009) and greater diarrhea occurrence (7 (4.7%) vs. 16 (11%), p = 0.049). No statistically significant differences in ventilator-associated pneumonia incidence (18 (12.2%) vs. 18 (12.3%), p = 0.965), 28-day mortality (46 (31.1%) vs. 40 (27.4%), p = 0.488), and other secondary outcomes were observed between groups. Thus, intermittent enteral nutrition was superior to continuous enteral nutrition in terms of time to reach the energetic target with the tolerance-driven administration protocol but was associated with higher diarrhea incidence. No statistically significant differences in the other secondary outcomes were observed.

Návaznosti

LM2023049, projekt VaV

Název: Český národní uzel Evropské sítě infrastruktur klinického výzkumu

Investor: Ministerstvo školství, mládeže a tělovýchovy ČR, CZECRIN - Czech National Node to the European Clinical Research Infrastructure Network

MUNI/A/1600/2023, interní kód MU

Název: Role fibrinogenu u operací skoliózy v dětském věku

Investor: Masarykova univerzita, Role fibrinogenu u operací skoliózy v dětském věku

Citovat

HRDÝ, Ondřej, Kamil VRBICA, Jaroslav DUBA, Martin SLEZÁK, Eva STRAŽEVSKÁ, Viktor AGALAREV, Miloš DUBA, Radka ŠTĚPÁNOVÁ, Adam SVOBODNÍK a Roman GÁL. Intermittent enteral nutrition shortens the time to achieve nutritional goals in critically ill patients. Scientific Reports. BERLIN: NATURE PORTFOLIO, 2025, roč. 15, č. 1, s. 1-11. ISSN 2045-2322. Dostupné z: https://dx.doi.org/10.1038/s41598-025-86633-4.

@article{2471449,
   author = {Hrdý, Ondřej and Vrbica, Kamil and Duba, Jaroslav and Slezák, Martin and Straževská, Eva and Agalarev, Viktor and Duba, Miloš and Štěpánová, Radka and Svobodník, Adam and Gál, Roman},
   article_location = {BERLIN},
   article_number = {1},
   doi = {http://dx.doi.org/10.1038/s41598-025-86633-4},
   keywords = {Critical care; Enteral nutrition; Intensive care unit; Gastric residual volume; Ventilator-associated pneumonia; Diarrhea},
   language = {eng},
   issn = {2045-2322},
   journal = {Scientific Reports},
   title = {Intermittent enteral nutrition shortens the time to achieve nutritional goals in critically ill patients},
   url = {https://www.nature.com/articles/s41598-025-86633-4},
   volume = {15},
   year = {2025}
}

TY  - JOUR
ID  - 2471449
AU  - Hrdý, Ondřej - Vrbica, Kamil - Duba, Jaroslav - Slezák, Martin - Straževská, Eva - Agalarev, Viktor - Duba, Miloš - Štěpánová, Radka - Svobodník, Adam - Gál, Roman
PY  - 2025
TI  - Intermittent enteral nutrition shortens the time to achieve nutritional goals in critically ill patients
JF  - Scientific Reports
VL  - 15
IS  - 1
SP  - 1-11
EP  - 1-11
PB  - NATURE PORTFOLIO
SN  - 20452322
KW  - Critical care
KW  - Enteral nutrition
KW  - Intensive care unit
KW  - Gastric residual volume
KW  - Ventilator-associated pneumonia
KW  - Diarrhea
UR  - https://www.nature.com/articles/s41598-025-86633-4
N2  - Nutritional support is associated with improved clinical outcomes in critically ill patients; however, loss of muscle mass during critical illness leads to weakness, delayed return to work, and increased healthcare consumption. Animal data have suggested that intermittent feeding decreases protein catabolism. This study was aimed at determining whether the mode of enteral nutrition administration might lead to differences in meeting nutritional goals, tolerance, and complications. A prospective, randomized, single-center clinical trial was conducted in four intensive care units in the Czech Republic. Critically ill adult patients with high nutritional risk were randomized to continuous or intermittent enteral nutrition administration through a tolerance-driven protocol. The primary outcome was the time to reach the energetic target. Secondary outcomes included assessment of tolerance (high gastric residual volume, vomitus, and diarrhea), complications (aspiration or ventilator-associated pneumonia), and 28-day mortality. A total of 300 patients were randomized, and 294 were analyzed: 148 in the continuous arm and 146 in the intermittent arm. Regarding the primary outcome, log-rank test indicated that the intermittent group, compared with continuous group, had a statistically significantly shorter time (p = 0.009) and greater diarrhea occurrence (7 (4.7%) vs. 16 (11%), p = 0.049). No statistically significant differences in ventilator-associated pneumonia incidence (18 (12.2%) vs. 18 (12.3%), p = 0.965), 28-day mortality (46 (31.1%) vs. 40 (27.4%), p = 0.488), and other secondary outcomes were observed between groups. Thus, intermittent enteral nutrition was superior to continuous enteral nutrition in terms of time to reach the energetic target with the tolerance-driven administration protocol but was associated with higher diarrhea incidence. No statistically significant differences in the other secondary outcomes were observed.
ER  -

HRDÝ, Ondřej, Kamil VRBICA, Jaroslav DUBA, Martin SLEZÁK, Eva STRAŽEVSKÁ, Viktor AGALAREV, Miloš DUBA, Radka ŠTĚPÁNOVÁ, Adam SVOBODNÍK a Roman GÁL. Intermittent enteral nutrition shortens the time to achieve nutritional goals in critically ill patients. \textit{Scientific Reports}. BERLIN: NATURE PORTFOLIO, 2025, roč.~15, č.~1, s.~1-11. ISSN~2045-2322. Dostupné z: https://dx.doi.org/10.1038/s41598-025-86633-4.

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