Effect of saline 0.9% or Plasma-Lyte 148 therapy on feeding intolerance in patients receiving nasogastric enteral nutrition

Sumeet Reddy, Michael Bailey, Richard Beasley, Rinaldo Bellomo, Diane Mackle, Alex Psirides, Paul Young

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2 Citations (Scopus)

Abstract

Objective: To compare the effect of Plasma-Lyte (PL)-148 and saline 0.9% (saline) on gastrointestinal (GI) feeding intolerance in mechanically ventilated patients receiving nasogastric (NG) feeding in an intensive care unit. Design and setting: A single-centre pilot study, nested within a multicentre, double-blind, cluster-randomised, double-crossover trial, performed in a mixed medical and surgical ICU. Participants: All adult patients who required crystalloid fluid therapy as part of the 0.9% Saline versus Plasma-Lyte 148 for Intensive Care Unit Fluid Therapy (SPLIT) trial, were expected to need mechanical ventilation for more than 48 hours and were receiving enteral nutrition exclusively by NG tube were eligible. We enrolled 69 patients and assigned 35 to PL-148 and 34 to saline. Interventions: We randomly allocated saline or PL-148 for four alternating 7-week blocks, with staff blinded to the solution. Main outcome measures: The primary outcome was the proportion of patients with GI feeding intolerance, defined as high gastric residual volume (GRV), diarrhoea or vomiting while receiving NG feeding in the ICU. The proportions of patients with each of high GRV, diarrhoea and vomiting were secondary outcomes. Results: In the PL-148 group, 21 of 35 patients (60.0%) developed GI feeding intolerance, compared with 22 of 34 patients (64.7%) in the saline group (odds ratio [OR], 0.82; 95% CI, 0.31-2.17; P = 0.69). A high GRV was seen in four of 35 patients (11.4%) in the PL-148 group, and in 11 of 34 patients (32.4%) in the saline group (OR, 0.27; 95% CI, 0.08-0.96; P = 0.04). Conclusion: Among mechanically ventilated patients receiving NG feeding, the use of PL-148, compared with saline, did not reduce the proportion of patients developing GI feeding intolerance, but was associated with a decreased incidence of high GRV.

Original languageEnglish
Pages (from-to)198-204
Number of pages7
JournalCritical Care and Resuscitation
Volume18
Issue number3
Publication statusPublished - 1 Sep 2016

Cite this

@article{0cfabde331f94c03bf91cb3a17f3ef5c,
title = "Effect of saline 0.9{\%} or Plasma-Lyte 148 therapy on feeding intolerance in patients receiving nasogastric enteral nutrition",
abstract = "Objective: To compare the effect of Plasma-Lyte (PL)-148 and saline 0.9{\%} (saline) on gastrointestinal (GI) feeding intolerance in mechanically ventilated patients receiving nasogastric (NG) feeding in an intensive care unit. Design and setting: A single-centre pilot study, nested within a multicentre, double-blind, cluster-randomised, double-crossover trial, performed in a mixed medical and surgical ICU. Participants: All adult patients who required crystalloid fluid therapy as part of the 0.9{\%} Saline versus Plasma-Lyte 148 for Intensive Care Unit Fluid Therapy (SPLIT) trial, were expected to need mechanical ventilation for more than 48 hours and were receiving enteral nutrition exclusively by NG tube were eligible. We enrolled 69 patients and assigned 35 to PL-148 and 34 to saline. Interventions: We randomly allocated saline or PL-148 for four alternating 7-week blocks, with staff blinded to the solution. Main outcome measures: The primary outcome was the proportion of patients with GI feeding intolerance, defined as high gastric residual volume (GRV), diarrhoea or vomiting while receiving NG feeding in the ICU. The proportions of patients with each of high GRV, diarrhoea and vomiting were secondary outcomes. Results: In the PL-148 group, 21 of 35 patients (60.0{\%}) developed GI feeding intolerance, compared with 22 of 34 patients (64.7{\%}) in the saline group (odds ratio [OR], 0.82; 95{\%} CI, 0.31-2.17; P = 0.69). A high GRV was seen in four of 35 patients (11.4{\%}) in the PL-148 group, and in 11 of 34 patients (32.4{\%}) in the saline group (OR, 0.27; 95{\%} CI, 0.08-0.96; P = 0.04). Conclusion: Among mechanically ventilated patients receiving NG feeding, the use of PL-148, compared with saline, did not reduce the proportion of patients developing GI feeding intolerance, but was associated with a decreased incidence of high GRV.",
author = "Sumeet Reddy and Michael Bailey and Richard Beasley and Rinaldo Bellomo and Diane Mackle and Alex Psirides and Paul Young",
year = "2016",
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volume = "18",
pages = "198--204",
journal = "Critical Care and Resuscitation",
issn = "1441-2772",
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Effect of saline 0.9% or Plasma-Lyte 148 therapy on feeding intolerance in patients receiving nasogastric enteral nutrition. / Reddy, Sumeet; Bailey, Michael; Beasley, Richard; Bellomo, Rinaldo; Mackle, Diane; Psirides, Alex; Young, Paul.

In: Critical Care and Resuscitation, Vol. 18, No. 3, 01.09.2016, p. 198-204.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Effect of saline 0.9% or Plasma-Lyte 148 therapy on feeding intolerance in patients receiving nasogastric enteral nutrition

AU - Reddy, Sumeet

AU - Bailey, Michael

AU - Beasley, Richard

AU - Bellomo, Rinaldo

AU - Mackle, Diane

AU - Psirides, Alex

AU - Young, Paul

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Objective: To compare the effect of Plasma-Lyte (PL)-148 and saline 0.9% (saline) on gastrointestinal (GI) feeding intolerance in mechanically ventilated patients receiving nasogastric (NG) feeding in an intensive care unit. Design and setting: A single-centre pilot study, nested within a multicentre, double-blind, cluster-randomised, double-crossover trial, performed in a mixed medical and surgical ICU. Participants: All adult patients who required crystalloid fluid therapy as part of the 0.9% Saline versus Plasma-Lyte 148 for Intensive Care Unit Fluid Therapy (SPLIT) trial, were expected to need mechanical ventilation for more than 48 hours and were receiving enteral nutrition exclusively by NG tube were eligible. We enrolled 69 patients and assigned 35 to PL-148 and 34 to saline. Interventions: We randomly allocated saline or PL-148 for four alternating 7-week blocks, with staff blinded to the solution. Main outcome measures: The primary outcome was the proportion of patients with GI feeding intolerance, defined as high gastric residual volume (GRV), diarrhoea or vomiting while receiving NG feeding in the ICU. The proportions of patients with each of high GRV, diarrhoea and vomiting were secondary outcomes. Results: In the PL-148 group, 21 of 35 patients (60.0%) developed GI feeding intolerance, compared with 22 of 34 patients (64.7%) in the saline group (odds ratio [OR], 0.82; 95% CI, 0.31-2.17; P = 0.69). A high GRV was seen in four of 35 patients (11.4%) in the PL-148 group, and in 11 of 34 patients (32.4%) in the saline group (OR, 0.27; 95% CI, 0.08-0.96; P = 0.04). Conclusion: Among mechanically ventilated patients receiving NG feeding, the use of PL-148, compared with saline, did not reduce the proportion of patients developing GI feeding intolerance, but was associated with a decreased incidence of high GRV.

AB - Objective: To compare the effect of Plasma-Lyte (PL)-148 and saline 0.9% (saline) on gastrointestinal (GI) feeding intolerance in mechanically ventilated patients receiving nasogastric (NG) feeding in an intensive care unit. Design and setting: A single-centre pilot study, nested within a multicentre, double-blind, cluster-randomised, double-crossover trial, performed in a mixed medical and surgical ICU. Participants: All adult patients who required crystalloid fluid therapy as part of the 0.9% Saline versus Plasma-Lyte 148 for Intensive Care Unit Fluid Therapy (SPLIT) trial, were expected to need mechanical ventilation for more than 48 hours and were receiving enteral nutrition exclusively by NG tube were eligible. We enrolled 69 patients and assigned 35 to PL-148 and 34 to saline. Interventions: We randomly allocated saline or PL-148 for four alternating 7-week blocks, with staff blinded to the solution. Main outcome measures: The primary outcome was the proportion of patients with GI feeding intolerance, defined as high gastric residual volume (GRV), diarrhoea or vomiting while receiving NG feeding in the ICU. The proportions of patients with each of high GRV, diarrhoea and vomiting were secondary outcomes. Results: In the PL-148 group, 21 of 35 patients (60.0%) developed GI feeding intolerance, compared with 22 of 34 patients (64.7%) in the saline group (odds ratio [OR], 0.82; 95% CI, 0.31-2.17; P = 0.69). A high GRV was seen in four of 35 patients (11.4%) in the PL-148 group, and in 11 of 34 patients (32.4%) in the saline group (OR, 0.27; 95% CI, 0.08-0.96; P = 0.04). Conclusion: Among mechanically ventilated patients receiving NG feeding, the use of PL-148, compared with saline, did not reduce the proportion of patients developing GI feeding intolerance, but was associated with a decreased incidence of high GRV.

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M3 - Article

AN - SCOPUS:84987680686

VL - 18

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EP - 204

JO - Critical Care and Resuscitation

JF - Critical Care and Resuscitation

SN - 1441-2772

IS - 3

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