Which feeding schedule is most appropriate for a critically ill patient with labile and poorly controlled blood glucose concentrations?

Which feeding schedule is most appropriate for a critically ill patient with labile and poorly controlled blood glucose concentrations?

• A. Bolus
• B. Continuous
• C. Gravity drip
• D. Nocturnal infusion

Answer: (B)

Continuous feeding minimizes fluctuations in substrate delivery, leading to steadier blood glucose levels and easier insulin titration in critically ill patients. When glucose control is labile, delivering nutrients at a constant rate reduces postprandial spikes and overall glycemic variability compared with feeding given as large boluses, a gravity drip with variable flow, or a limited overnight infusion. Bolus schedules produce rapid glucose influx that can trigger high peaks and subsequent dips; gravity drip lacks precise control of the delivery rate, adding to variability; nocturnal infusion confines delivery to overnight hours and doesn’t address daytime fluctuations. Continuous, pump-delivered feeding provides a predictable, ongoing supply that supports more stable glycemic management.

Continuous feeding minimizes fluctuations in substrate delivery, leading to steadier blood glucose levels and easier insulin titration in critically ill patients. When glucose control is labile, delivering nutrients at a constant rate reduces postprandial spikes and overall glycemic variability compared with feeding given as large boluses, a gravity drip with variable flow, or a limited overnight infusion. Bolus schedules produce rapid glucose influx that can trigger high peaks and subsequent dips; gravity drip lacks precise control of the delivery rate, adding to variability; nocturnal infusion confines delivery to overnight hours and doesn’t address daytime fluctuations. Continuous, pump-delivered feeding provides a predictable, ongoing supply that supports more stable glycemic management.