Comparison of intermittent and bolus enteral feeding methods on enteral feeding intolerance of patients with sepsis: a triple-blind controlled trial in intensive care units

Background: Recent trials have shown controversial results on which enteral feeding methods has a lower risk of enteral feeding intolerance. Therefore, we aimed to compare two methods of bolus and intermittent feeding on enteral feeding intolerance of patients with sepsis

Methods: This triple-blind randomized controlled trial was conducted on 60 patients with sepsis, who were fed through tubes for at least 3 days. The patients were randomly assigned into bolus feeding, intermittent feeding, and control groups. Enteral feeding intolerance of all patients was recorded in 3 consecutive days by a researcher-made checklist including the data on gastric residual volume, vomiting, diarrhea, constipation, and abdominal distension

Results: There were no significant differences between the three studied groups in none of the intervention days pertaining to constipation, diarrhea, vomiting, abdominal distention, and gastric residual volume [p > 0.05]. Also, no statistically significant difference was found between all variables in the three studied groups during the 3 days [p > 0.05]

Conclusion: As enteral feeding intolerance of patients with sepsis was similar in both bolus and intermittent feeding methods, it can be concluded that bolus method can still be used as a standard method to decrease the risk of enteral feeding intolerance if it is used properly

most sensitive double-marker method of cardiac isoenzymes of creatinine kinase, troponin I, and myoglobin in different time periods for diagnosing acute myocardial infarction

Myocardial infarction is among the most common diagnoses in patients admitted to hospitals in western countries, and its rapid diagnosis is of utmost importance. This study was conducted to determine the most sensitive double-marker cardiac isoenzyme of creatinine kinase, troponin I, and myoglobin for diagnosing acute myocardial infarction. This was an observational-analytic research on a diagnostic test conducted on 256 patients who had referred to the emergency department with chest pain from 4 to 24 hours before their referral. They were sorted equally into two groups of 4-14 hours and 15-24 hours from onset of pain, each group including 128 patients. In the first time period, the combination of troponin and myoglobin had the highest sensitivity [sensitivity = 97.3%, specificity = 98.1%], whereas the combination of double-marker and troponin proved the most sensitive [sensitivity = 100%, specificity = 96.3%].The double-marker combination of troponin and myoglobin is more appropriate for the first time period [i.e. during the first 24 hours from the onset of chest pain],while it would be more helpful to use the combination of troponin during the second period of time.