• Decrease the risk of aspiration especially in tick paralysis, snake bite patients

• Decrease the risk of silent reflux especially in the recumbent patient

• Bolus feeds is more physiological and reduces gastric acid secretion

• Oesophageal tubes result in less oesophagitis than ones that traverse the LES (lower esophageal sphincter) 

• In healthy humans, protein synthesis is superior in bolus fed individuals (Patel et al).  A similar study is currently on-going in ICU patients (ProBoNo study). 

• CRI induces a degree of insulin resistance, and exaggerated leptin secretion (Gonzalez et al).  

• CRI means that the animal doesn’t get inter-digestive periods of fasting, and hence autophagy is inhibited. 

​

Articles

Gonzalez JT, Dirks ML, Holwerda AM, Kouw IWK, van Loon LJC. Intermittent versus continuous enteral nutrition attenuates increases in insulin and leptin during short-term bed rest. Eur J Appl Physiol. 2020 Sep;120(9):2083-2094. 

 

Patel JJ, Rosenthal MD, Heyland DK. Intermittent versus continuous feeding in critically ill adults. Curr Opin Clin Nutr Metab Care. 2018 Mar;21(2):116-120. 

 

Reinhold S, et al.,  Protein delivery in intermittent and continuous enteral nutrition with a protein-rich formula in critically ill patients-a protocol for the prospective randomized controlled proof-of-concept Protein Bolus Nutrition (Pro BoNo) study. Trials. 2020 Aug 25;21(1):740. 

 

Ichimaru S. Methods of Enteral Nutrition Administration in Critically Ill Patients: Continuous, Cyclic, Intermittent, and Bolus Feeding. Nutr Clin Pract. 2018 Dec;33(6):790-795. 

 

Wang, Y., Zhu, W. & Luo, Br. Continuous feeding versus intermittent bolus feeding for premature infants with low birth weight: a meta-analysis of randomized controlled trials. Eur J Clin Nutr 74, 775–783 (2020). https://doi.org/10.1038/s41430-019-0522-x

​

Nutrition Articles

• Chan DL, Freeman LM. Nutrition in critical illness. Vet Clin North Am Small Anim Pract. 36(6):1225-1241, 2006.

• Gallagher-Allred CR, Voss AC, Finn SC, McCamish MA. Malnutrition and clinical outcomes: the case for medical nutrition therapy. J Am Diet Assoc 96(4):361-366, 1996.

• Giner M, Laviano A, Meguid MM, et al. In 1995 a correlation between malnutrition and poor outcome in critically ill patients still exists. Nutr 12(1):23-29, 1996.

• Gramlich L, Kichian K, Pinilla J, et al. Does enteral nutrition compared to parenteral nutrition result in better outcomes in critically ill adult patients? A systematic review of the literature. Nutrition 20(10):843-848, 2004.

• Griffiths RD, Bongers T. Nutrition support for patients in the intensive care unit. Postgrad Med J 81:629-636, 2005.

• Griffiths RD. Specialized nutrition support in critically ill patients. Curr Opin Crit Care 9:249-259, 2003.

• Labow BI, Souba WW. Glutamine. World J Surg 24(12):1503-1513, 2000.

• Larsen JA. Enteral nutrition and tube feeding. In: Fascetti AJ, Delaney SJ (eds). Applied Veterinary Clinical Nutrition. Wiley-Blackwell: Ames, Iowa, 2012. Pp. 329-352.

• Marik PE Zaloga GP. Early enteral nutrition in acutely ill patients: A systematic review. Critical Care Med 29(12):2264-2270, 2001.

• Martin CM, Doig GS, Heyland DK, et al. Multicentre, cluster-randomized clinical trial of algorithms for critical-care enteral and parenteral therapy (ACCEPT). CMAJ 170(2):197-204, 2004.

• Martindale RG, Shikora SA, Nishikawa R, Siepler JK. In: American Society for Parenteral and Enteral Nutrition (ed). Nutritional Considerations in the Intensive Care Unit: Science, Rationale, and Practice. City, State: Kendall/Hunt Publishing Company; 2002.

• McClave SA, Heyland DK. The physiologic response and associated clinical benefits from provision of early enteral nutrition. Nutr Clin Pract. 24(3):305-315, 2009.

• Mohr AJ, Leisewitz AL, Jacobson LS, et al. Effect of early enteral nutrition on intestinal permeability, intestinal protein loss, and outcome in dogs with severe parvoviral enteritis. J Vet Intern Med 17(6):791-798, 2003.

• Monk DN, Plank LD, Franch-Arcas G, et al. Sequential changes in the metabolic response in critically injured patients during the first 25 days after blunt trauma. Ann Surg 223:395-405, 1996.

• Orosz SE. Perioperative nutrition for birds. Proc Annu Conf Assoc Avian Vet; 2009. Pp. 37-44.

• Qin HL, Su ZD, Gao Q, Lin QT. Early intrajejunal nutrition: Bacterial translocation and gut barrier function of severe acute pancreatitis in dogs. Hepatobiliary Pancreat Dis Int 1(1):150-154, 2002.

• Saker KE, Remillard RL. Critical Care Nutrition and Enteral-Assisted Feeding. In Small Animal Clinical Nutrition, 5th ed. Hand M, Thatcher C, Remillard RL, Roudebush P, Novotny B. eds. 2010. MMI, Topeka, KS.