Tube feeding study heralds revolution in care for patients

 
9 October 2013

Critically ill patients may recover more quickly if they are given three tube feeds a day rather than fed continuously via a line into the stomach, London research revealed today.

A seven-year study involving patients at King’s College and Whittington hospitals turned conventional thinking on its head after analysing how their muscles wasted away during stays in intensive care units.

Research involving four London hospital trusts and four universities found the loss of muscle power, which can affect quality of life for up to five years, was greater for those patients fed through their nose 24 hours a day.

This suggested that more feeding using a glucose and protein mix was unlikely to help. Further trials are now planned to establish whether switching the feeding to three two-hour periods causes less damage to muscles while the patient is immobile.

Research head Dr Zudin Puthucheary said: “We found that muscle protein is significantly broken down in the first week of critical illness, resulting in two per cent loss of muscle mass per day.

“Muscle protein synthesis levels were depressed at the start of illness but were recovering by the end of the first week, which was a surprise. This is an exciting discovery as we now know more about how and why people waste away when they’re critically ill.”

The findings are based on testing of 63 patients admitted for urgent treatment to conditions including trauma injuries, brain bleeds and liver failure.

They were presented today at the European Society of Intensive Care Medicine conference in Paris by Dr Nicholas Hart, a consultant at Guy’s and St Thomas’ hospital.

He said: “I can now honestly say that I don’t believe continuous feeding is as good a thing as we might think. What we suggest is that we give it to patients in two-hour slots, like a long meal.

“Our hypothesis is that continuous feeding is not good for you and is not good for muscle physiology. What we see is a revolution in critical care.”

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