BACKGROUND AND AIMS: The objective of this study was to evaluate the relationship between increasing success with enteral nutrition (EN) and acquired infection in the Intensive Care Unit (ICU). METHODS: We conducted a prospective, multicenter, observational study in 3 Medical/Surgical ICUs. We included patients mechanically ventilated in ICU more than 72 h and who received enteral nutrition only. Charts were reviewed to determine success with EN delivery and clinical outcomes. Suspected infections were adjudicated by 2 or more clinicians to determine the presence or absence of infection (rated as either probable or possible infection). RESULTS: Of the 207 patients included in this analysis, the average age was 62.0 years; APACHE II score was 23.3; BMI: 28.5; and 73% were medical. Overall, patients received 48.9% (range 0-120%) of their energy and 45.1% (range 0-120%) of their protein requirements from EN. Overall, 25.1% developed an infection after 72 h from admission, 21.7% developed an infection after 96 h from admission, and the 28-day mortality was 29.0%. In a regression model, greater amounts of energy and protein were consistently associated with a reduction in infection. However, estimates only achieved levels near statistical significance for risk of at least 1 probable infection after >96 h (Odds Ratio [0R]: 0.32, 95% Confidence Interval [CI]: 0.10-1.02, p=0.054 and OR: 0.40, 95% CI: 0.18-0.89, p=0.024 per 1000 kcal/day energy and 30 grams/day protein, respectively). In all cases, the OR was lower when considering infections that developed after 96 h compared to infections that developed after 72 h and when considering 'Probable' infections compared to all infections which included 'Possible' infections. CONCLUSIONS: Successful EN may be associated with a reduction in infectious complications, particularly after 96 h of ICU admission.
BACKGROUND AND AIMS: The objective of this study was to evaluate the relationship between increasing success with enteral nutrition (EN) and acquired infection in the Intensive Care Unit (ICU). METHODS: We conducted a prospective, multicenter, observational study in 3 Medical/Surgical ICUs. We included patients mechanically ventilated in ICU more than 72 h and who received enteral nutrition only. Charts were reviewed to determine success with EN delivery and clinical outcomes. Suspected infections were adjudicated by 2 or more clinicians to determine the presence or absence of infection (rated as either probable or possible infection). RESULTS: Of the 207 patients included in this analysis, the average age was 62.0 years; APACHE II score was 23.3; BMI: 28.5; and 73% were medical. Overall, patients received 48.9% (range 0-120%) of their energy and 45.1% (range 0-120%) of their protein requirements from EN. Overall, 25.1% developed an infection after 72 h from admission, 21.7% developed an infection after 96 h from admission, and the 28-day mortality was 29.0%. In a regression model, greater amounts of energy and protein were consistently associated with a reduction in infection. However, estimates only achieved levels near statistical significance for risk of at least 1 probable infection after >96 h (Odds Ratio [0R]: 0.32, 95% Confidence Interval [CI]: 0.10-1.02, p=0.054 and OR: 0.40, 95% CI: 0.18-0.89, p=0.024 per 1000 kcal/day energy and 30 grams/day protein, respectively). In all cases, the OR was lower when considering infections that developed after 96 h compared to infections that developed after 72 h and when considering 'Probable' infections compared to all infections which included 'Possible' infections. CONCLUSIONS: Successful EN may be associated with a reduction in infectious complications, particularly after 96 h of ICU admission.
Authors: Sara Wilson; Nagendra Y Madisi; Adel Bassily-Marcus; Anthony Manasia; John Oropello; Roopa Kohli-Seth Journal: World J Crit Care Med Date: 2016-08-04
Authors: Miroslav P Peev; D Dante Yeh; Sadeq A Quraishi; Polina Osler; Yuchiao Chang; Erin Gillis; Caitlin E Albano; Sharon Darak; George C Velmahos Journal: JPEN J Parenter Enteral Nutr Date: 2014-04-07 Impact factor: 4.016
Authors: Nilesh M Mehta; Lori J Bechard; Naomi Cahill; Miao Wang; Andrew Day; Christopher P Duggan; Daren K Heyland Journal: Crit Care Med Date: 2012-07 Impact factor: 7.598
Authors: Nicolette J Wierdsma; Job H C Peters; Peter J M Weijs; Martjin B Keur; Armand R J Girbes; Ad A van Bodegraven; Albertus Beishuizen Journal: Crit Care Date: 2011-11-09 Impact factor: 9.097