Aspiration is a major risk factor for the development of pneumonia. Critically ill patients are at higher risk due to several factors. Many physicians routinely hold feeding prior to extubation due to usual practice, but evidence is scarce that continuing feeding increases the risk of aspiration. This study was designed to determine whether continuing enteral feeding prior to a scheduled extubation is associated with a higher risk of aspiration.

This is a prospective, cohort study done in the critical units of Chong Hua Hospital. All intubated patients, (18 years and above) started on enteral feeding via nasogastric tube for at least 24 hours prior to planned extubation, were included. Patients were grouped into either Continuous or Withold Group (feeding withheld for at least 3 hours before and 2 hours after extubation). The following events were observed: aspiration of gastric contents during and after extubation, vomiting within 2 hours after extubation, and reintubation within 24 hours from extubation. In the event of reintubation, vomiting and aspiration of gastric content during the process of reintubation was documented.

Seventy patients were included in the study. There was no documented aspiration in both groups. In the Withhold group, feeding was withheld with a mean average of 7.11 + 2.35 hours and the amount of calories withheld ranged from as low as 166 calories to as high as 800 calories (320 + 144.28).

Continuing nasogastric feeding during the peri-extubation period does not increase the risk of aspiration and allows for delivery of optimal nutrition to critically ill patient.