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Delaying Intravenous Feeding of ICU Patients May Aid Recovery
Date:6/29/2011

By Jenifer Goodwin
HealthDay Reporter

WEDNESDAY, June 29 (HealthDay News) -- Temporarily withholding intravenous feedings for seriously ill patients in the intensive care unit may actually help them leave the hospital faster, new research finds.

Patients in the ICU are often too sick to feed themselves, or are on ventilators, so it's common for doctors to try feeding them through a tube directly into their stomach, and if that fails, the next step is offering nutrients intravenously, experts said. Intravenous feedings are administered into a vein.

In Europe, guidelines call for starting intravenous feedings soon after tube feeding fails, while in the United States, guidelines call for holding off about a week, as long as patients aren't already malnourished.

According to the new, multi-center trial by researchers in Belgium, the U.S. guidelines may be better.

Researchers divided 4,600 ICU patients into two groups: one received IV nutrition within two days of entering the ICU, the other had IV nutrition withheld until Day 8. (All patients received fluids to keep them hydrated.)

Death rates in the hospital and 90 days after discharge were the same in both groups. But patients who weren't fed until Day 8 on average spent one day less in the ICU, and were discharged slightly sooner from the hospital. (About 45.5 percent of people who weren't fed for a week spent more than 15 days in the hospital compared to 50.1 percent of those fed sooner.) They had fewer infections and a lower incidence of liver damage.

They were also 10 percent less likely to be on a ventilator for more than two days and less likely to need dialysis because of renal failure. They also incurred slightly lower costs, about $1,600 less per patient.

"What we found was that the recovery of the patients who did not get the [IV] feeding right away was quicker. They had less need for mechanical ventilation, dialysis due to kidn
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