Faster Recovery Of ICU Patients May Be Achieved Through Delaying Intravenous Feeding

A new study has discovered that a temporary withhold on intravenous feeding on a patient, who is seriously ill inside an intensive care unit, can actually lead to an earlier hospital discharge for them.

ICU patients normally have difficulty with feeding themselves or they may be on ventilators, making it necessary for doctors to feed them using a tube that directly transports food the stomach. When that cannot be achieved, the next best course for doctors is to introduce nutrients to the body through intravenous feedings - tubes that directly administer food or nutrients into patients’ veins.

Different countries impose different guidelines when it comes to intravenous feedings. In Europe, they are started as soon as tube feeding the patient has failed. Whereas in the US, if patients are not considered malnourished, intravenous feedings are held off for at least a week.

In Belgium, the multi-centre trial conducted by researchers shows that the US guidelines are more effective.

The study was conducted through dividing ICU patients of 4,600 into two sets: the first got IV nutrition two days after they entered the ICU and the second got IV nutrition 8 days after their entrance to the ICU. (All of the participants were kept hydrated through constant administration of fluids.)

Results showed the same death rates and effects 90 days after being released from the hospital for both groups. The second group (who received IV feedings only after 8 days) were found to have one day less spent in the ICU and got out of the hospital sooner than the first group. (45.5 percent patients from those of the second group spent 15 days or more in the hospital whilst 50.1 percent who belong from the first group spent virtually the same period). Also, those who got held off on IV feeding until their eight day of stay in the ICU showed fewer infections, as well as a lower chance of damage to the liver.

The director of the Department of Intensive Care Medicine at the University of Leuven in Belgium and the senior researcher of the study, Dr. Greet Van der Berghe stated that there was a quicker recovery of patients who did not get the intravenous feeding right away. This is because their need for mechanical ventilation and dialysis of kidney failure was less - plus there were fewer infection cases handled. He went on to say that because of all the mentioned factors, the patients were able to leave the ICU quicker, thus were discharged from the hospital a lot quicker, as well.

On the necessity of the research, Dr. Thomas R. Ziegler, a medicine professor at Atlanta’s Emory University School of Medicine, said that the said study is significant since an ICU routine practice - that is, IV feeding is the subject done to the rigors of a considerable, randomised clincal trial that was long overdue.

He stressed, though, that the study’s findings must be interpreted properly. As IV feeding plays an important role in the nutrition of seriously ill ICU patients, the likelihood of a patient starving to death cannot be denied. Up to now, too, malnutrition still stands to be one of the major issues in ICU patients.

Ziegler further explained that the sufficing nutritional status is critical in the optimal performance and function of the cell and organ and faster recovery from illness.

The authors of the study cannot exactly pinpoint the correlation of holding off on IV feeding in assisting faster patient recovery. However, they speculate that eating suppresses autophagy - and therefore, sends the signal that everything is fine which then speeds up the process of healing and recovery.