• Marcel F Dvorak, Vanessa K Noonan, Lise Bélanger, Birthe Bruun, Peter C Wing, Michael C Boyd, and Charles Fisher.
• Division of Spine, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada. mdvorak@vanhosp.bc.ca
• Spine. 2004 May 1; 29 (9): E175-80.

Study DesignA prospective randomized clinical pilot study to compare early versus late enteral feeding in patients with acute cervical spinal cord injury.ObjectivesTo compare the incidence of infections in patients with acute cervical spinal cord injury who received early versus late enteral feeding. Secondary objectives included assessing nutritional status, feeding tolerance, the number of ventilator hours, and acute-care hospital length of stay.Summary Of Background DataEarly nutritional support has been found to be beneficial in critically ill patients. However, the same benefits may not be realized in patients with acute cervical spinal cord injury because of their unique nutritional challenges.MethodsEligible patients were randomized to early feeding (initiated before 72 hours after injury) and late (initiated more than 120 hours after injury). Patients were stratified on the basis of their neurologic level. Patients were assessed daily for the first 15 days. After that time, infections (according to Center for Disease Control criteria), ventilator hours, and length of acute-care hospital stay were tracked.ResultsTwenty-three patients met the eligibility criteria, and 17 patients were included in the analysis. There were 7 patients in the early group and 10 in the late group. The early group had a mean of 2.4 +/- 1.5 infections compared with the late group, which had a mean of 1.7 +/- 1.1 infections. Secondary outcomes were not substantially different between the two groups.ConclusionsThis pilot study failed to detect any differences in the incidence of infection, nutritional status, feeding complications, number of ventilator hours, or length of stay between patients receiving early versus late initiation of enteral feeding. These data will assist in the determination of an adequate sample size for future studies.

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