Night fasting as an alternative to improve nutritional support and glycaemic control in hospitalised patients with exclusive enteral nutrition

Enteral nutrition (EN) assists in the nutritional status of hospitalised patients unable to feed orally. The aim of this study was to determine which method—continuous EN or discontinuous EN, a diet in which the infusion is discontinued for 4h during the night,—is more effective in meeting nutrient recommendations and improving glycaemic control and biochemical parameters related to protein anabolism. Patients were divided into two groups: discontinuous (EN administered in mL/h, 18h/day, 4-h night fasting) and continuous (EN administered in mL/h, 22h/day). All patients with EN receive the diet over a 22-h daily period, in which the diet is suspended for two hours/day for daily hospital routines such as bathing, and physiotherapy, and followed for seven days. Evaluated data: prescribed and administered volume, calories, protein, and fibre; capillary blood glucose; erythrogram; serum albumin. 52 patients were followed-up, with 23 (44.2%) in the discontinuous group and 29 (55.8%) in the continuous group. Compared with the continuous group, the discontinuous group received volumes closer to those prescribed, equal or higher calories, and more protein. The capillary glucose values were within the reference range in the discontinuous group, while the continuous group presented elevated values. Both groups presented hypoalbuminaemia, haemoglobin, and haematocrit below the reference values; however, in the discontinuous group, the serum albumin values improved during hospitalisation relative to the continuous. The method involving discontinuation of EN for 4h was more effective in meeting nutrient recommendations compared with the continuous method. Additionally, in the discontinuous group, we observed a better control of glycaemia when compared to that of the continuous group. La nutrición enteral (NE) ayuda en la nutrición de pacientes imposibilitados de alimentarse por vía oral. El objetivo fue determinar si el método discontinuo, en el que suspende la infusión de la nutrición durante 4 h en la noche, es más eficaz que el continuo para atender las recomendaciones de nutrientes, mejora del control glucémico y los parámetros bioquímicos relacionados con el anabolismo proteico. Los pacientes fueron divididos en 2 grupos: discontinuo (NE administrada en ml/h, 18h/día, 4 h en ayuno nocturno) y continuo (NE administrada en ml/h, 22h/día). La colecta de datos se inició 72h después de la admisión y continuó durante 7 días. Datos evaluados: volumen prescrito y administr