DefinePK hosts the largest index of Pakistani journals, research articles, news headlines, and videos. It also offers chapter-level book search.
Title: Frequency of Ventilator Associated Pneumonia in Patientsof ContinuousFeed versus Bolus Enteral Feed
Authors: Muhammad Ahmad, Mahboob Meer, Syed Mazhar Ali Naqvi, Muhammad Hussain, Sabir Khan, Nadeem Siddique
Journal: Pakistan Armed Forces Medical Journal (PAFMJ)
Publisher: Army Medical College, Rawalpindi.
Country: Pakistan
Year: 2023
Volume: 73
Issue: Supplementary 1
Language: English
DOI: 10.51253/pafmj.v73iSUPPL-1.3180
Keywords: BolusContinuous feedEnteral feedVentilator associated pneumonia
Objective: To determine the frequency of ventilator associated pneumonia in continuous feed vs bolus enteral feeding.
Study Design: Comparative cross sectional study.
Place and Duration of Study: Department of intensive care unit, Services Hospital, Lahore and Services Institute of Medical Sciences, Lahore Pakistan, from Jan to Jun 2019.
Methodology: In this study the cases of both genders with age more than 18 years were enrolled. Patients with Previous History of gastroesophageal reflux disease, Hiatus Hernia, Esophageal & Abdominal Surgery, Gastrointestinal Bleed and those admitted already with Pneumonia, APACHE Score 20 or greater and those with Acute respiratory distress syndromewere excluded. The cases admitted in intensive care unit and requiring mechanical ventilation fulfilling inclusion and exclusion criteria were enrolled in this study. Continuous feed was offered to cases in Group A and bolus to those in B andwere looked for development of ventilator associated pneumonia.
Results: In this study, eighty cases (40 per Group) were enrolled. There were 26(65%) vs 25(62.5%) males in Group A and B respectively. The mean age was 51.85±12.61 vs 51.48±10.92 with p=0.88 in Group A and B. Mean ICU stay in Group A and B was 6.40±5.07 and 5.50±2.63 (p=0.32). Ventilator associated pneumonia was observed in 4(10%) vs 6(15%) cases in Group A and B respectively (p=0.74). Mean time for development of ventilator associated pneumonia in Group A and B was 4.67±1.15vs 4.80±1.09 day with p= 0.60.
Conclusion: Ventilator associated pneumonia was seen more in cases of bolus vs continuous fee
To determine the frequency of ventilator associated pneumonia (VAP) in patients receiving continuous enteral feeding versus bolus enteral feeding.
A comparative cross-sectional study conducted in the intensive care unit of Services Hospital and Services Institute of Medical Sciences, Lahore, Pakistan, from January to June 2019. Eighty adult patients (over 18 years) requiring mechanical ventilation were enrolled and divided into two groups: Group A (continuous feed) and Group B (bolus feed). Patients with specific pre-existing conditions or high APACHE scores were excluded. VAP was assessed daily based on fever, purulent secretions, leucocytosis, new radiological signs of pulmonary infection, and bacteriological evidence. Data was analyzed using independent sample t-tests and chi-square tests.
graph TD
A["Enroll Patients requiring Mechanical Ventilation"] --> B["Apply Inclusion/Exclusion Criteria"];
B -- Meets Criteria --> C["Divide into Group A"Continuous Feed" and Group B"Bolus Feed""];
C --> D["Administer Enteral Feed"];
D --> E["Daily Assess for VAP Signs & Symptoms"];
E --> F["Collect Data"];
F --> G["Analyze Data t-test, Chi-square"];
G --> H["Draw Conclusions"];
The study found a slightly higher incidence of VAP in patients receiving bolus enteral feeding compared to continuous feeding, but this difference was not statistically significant. The findings are comparable to previous studies, some of which also indicated a higher risk of VAP with bolus feeding, while others found no significant difference. The discussion highlights that while bolus feeding might be associated with a higher risk of aspiration due to decreased lower esophageal pressure, other factors like gastric residual volume and feeding tube type also play a role. The authors suggest that a large sample randomized controlled trial is needed to confirm these results.
Ventilator associated pneumonia (VAP) was observed in 4 (10%) patients in the continuous feed group (Group A) and 6 (15%) patients in the bolus feed group (Group B). The difference in VAP frequency between the two groups was not statistically significant (p=0.74). The mean time to development of VAP was also similar between the groups (4.67±1.15 days for Group A vs. 4.80±1.09 days for Group B, p=0.60).
Ventilator associated pneumonia was observed more frequently in patients receiving bolus enteral feed compared to continuous feed, although this difference was not statistically significant. Further research with larger sample sizes is recommended to confirm these findings.
1. Study Duration: The study was conducted from January to June 2019. (Confirmed in Methodology section).
2. Sample Size: Eighty cases were enrolled, with 40 in each group. (Confirmed in Methodology and Results sections).
3. VAP Incidence: VAP was observed in 10% of the continuous feed group and 15% of the bolus feed group. (Confirmed in Results section).
Loading PDF...
Loading Statistics...