Investigating the Effect of Two Methods of Continuous and Bolus Enteral Nutrition on Serum Albumin and Prealbumin levels in Patient with Mechanical Ventilation: A randomized clinical trial

Javad Seyyedi , Zahra Rooddehghan^* , Mostafa Mohammadi, and Shima Haghani

Background: Albumin and prealbumin proteins are indicators of nutritional adequacy in critically ill patients who receive enteral nutrition. The aim of this study was to determine the effect of continuous and bolus enteral feedings on serum albumin and prealbumin levels in patients with mechanical ventilation.

Methods: patients with mechanical ventilation admitted to the intensive care unit were randomly divided into two intervention (17 patients) and control (17 patients) groups. The intervention group was fed by continuous feeding and the control group was fed by bolus feeding through nasoagastric tube  for one week. Before and one weeks after the start of the study, descriptive variables and serum albumin and prealbumin levels of patients were measured.

Results: No significant difference was found in serum albumin levels between the two groups, but prealbumin level was higher in the intervention group than in the control group (control group: 0.12 ± 0.06, intervention group: 0.02 ± 0.15 and p = 0.08). The serum levels of prealbumin in the intervention group at the end of the study had a significant increase compared to the beginning of the study (before the intervention: 0.11 ± 0.06, after the intervention: 0.15 ± 0.02 and p = 0.004). However, intra-group changes in albumin level in the control group were not statistically significant.

Conclusion: Continuous feeding method improved serum albumin levels in patients with mechanical ventilation. Therefore, the continuous feeding method could be an alternative to the bolus feeding method. Further research with more samples and longer follow-up is recommended.

Keywords: Bolus feeding, Continuous feeding, Malnutrition, Intensive care unit, Albumin, Pre-albumin, Enteral Nutrition