Continuous versus intermittent feeding of the critically ill: have we made progress?

PURPOSE OF REVIEW: Despite the lack of high-quality data for many years, the discussion on the best modality for enteral nutrition has been going on with little changes pertaining in recent guidelines. The present work aims to provide an overview on the different arguments in favour of either continuous or noncontinuous modes of enteral feed administration, emphasizing both clinical and pathophysiological aspects and comparing their relevance.

RECENT FINDINGS: Different physiological effects deriving from enteral nutrition modes and that could impact on outcomes of care under critical illness settings are examined, such as glycaemic control and gastrointestinal motility. A further area of attention where recent efforts have been focusing is the issue of muscle and weakness under conditions of critical care.

SUMMARY: A clinical equipoise continues to characterize the analysis that can be drawn from examining the most recent research work on the subject, allowing to infer that the most practical mode in terms of the interest of patient safety and comfort has to be privileged in day-to-day clinical care.