Should We Interrupt Enteral Feeding Before Extubating Mechanically Ventilated Patients?

Holding enteral feeding for several hours prior to extubation is a standard practice in many intensive care units (ICUs); this protocol is driven by a concern for aspiration should the patient require reintubation. Although this is a plausible risk, the data to support interruption in nutrition are limited.

French investigators randomized 22 ICUs to use continuous enteral feeding or 6 hours of fasting and gastric suctioning prior to extubation. About 1000 patients who were supported with mechanical ventilation for at least 48 hours and with enteral nutrition for at least 1 day were included. Assessment of readiness for extubation was determined by local practice. About one third of patients had risk factors for extubation failure.

During the …