The impact of low-dose enteral nutrition administered at varying rates on gastric emptying in patients with large hemispheric infarction undergoing therapeutic hypothermia: a retrospective analysis.

Purpose: understanding gastric emptying at different rates of low-dose enteral nutrition is crucial for managing enteral feeding during therapeutic hypothermia (TH).

Methods

this study retrospectively reviewed the records of 42 patients who received TH at a single neurological intensive care unit. Patients received either 10 ml/h or 30 ml/h feeding. The gastric residual volumes (GRVs) were collected daily for 7 days during TH. In addition, demographic characteristics and disease severity (APACHE-II score) were also collected.

Results

GRVs in the 30 ml/h group were significantly higher than in the 10 ml/h group (p < 0.05). Both groups showed an initial increase in GRVs, peaking on day 2 (39.99 ± 17.73 ml vs 102.74 ± 43.19 ml, p = 0.000), followed by a gradual decrease. There was no significant difference in vomiting (4.0 % vs 11.8 %, p = 0.079) or ventilator associated pneumonia (VAP) incidence (8.0 % vs 17.6 %, p = 0.898) between the groups.

Conclusions

patients with large hemispheric infarction may likely tolerate an initial feeding rate of 30 ml/h during TH. Feeding rates should be gradually increased from day 3 based on patient condition.