Literature DB >> 27652209

Enteral nutrition administration in a surgical intensive care unit: Achieving goals with better strategies.

Sara Wilson1, Nagendra Y Madisi1, Adel Bassily-Marcus1, Anthony Manasia1, John Oropello1, Roopa Kohli-Seth1.   

Abstract

AIM: To evaluate the impact of an enteral feeding protocol on administration of nutrition to surgical intensive care unit (SICU) patients.
METHODS: A retrospective chart review was conducted on patients initiated on enteral nutrition (EN) support during their stay in a 14 bed SICU. Data collected over a seven-day period included date of tube feed initiation, rate initiated, subsequent hourly rates, volume provided daily, and the nature and length of interruptions. The six months prior to implementation of the feeding protocol (pre-intervention) and six months after implementation (post-intervention) were compared. One hundred and four patients met criteria for inclusion; 53 were pre-intervention and 51 post-intervention.
RESULTS: Of the 624 patients who received nutrition support during the review period, 104 met the criteria for inclusion in the study. Of the 104 patients who met criteria outlined for inclusion, 64 reached the calculated goal rate (pre = 28 and post = 36). The median time to achieve the goal rate was significantly shorter in the post-intervention phase (3 d vs 6 d; P = 0.01). The time to achieve the total recommended daily volume showed a non-significant decline in the post-intervention phase (P = 0.24) and the overall volume administered daily was higher in the post-intervention phase (61.6% vs 53.5%; P = 0.07). While the overall interruptions data did not reach statistical significance, undocumented interruptions (interruptions for unknown reasons) were lower in the post-intervention phase (pre = 23/124, post = 9/96; P = 0.06).
CONCLUSION: A protocol delineating the initiation and advancement of EN support coupled with ongoing education can improve administration of nutrition to SICU patients.

Entities:  

Keywords:  Critical care; Enteral nutrition; Nutrition support; Protocol; Surgical critical care

Year:  2016        PMID: 27652209      PMCID: PMC4986545          DOI: 10.5492/wjccm.v5.i3.180

Source DB:  PubMed          Journal:  World J Crit Care Med        ISSN: 2220-3141


  19 in total

1.  Early enteral nutrition and outcomes of critically ill patients treated with vasopressors and mechanical ventilation.

Authors:  Imran Khalid; Pratik Doshi; Bruno DiGiovine
Journal:  Am J Crit Care       Date:  2010-05       Impact factor: 2.228

2.  Impact of enteral feeding protocols on enteral nutrition delivery: results of a multicenter observational study.

Authors:  Daren K Heyland; Naomi E Cahill; Rupinder Dhaliwal; Xiaoqun Sun; Andrew G Day; Stephen A McClave
Journal:  JPEN J Parenter Enteral Nutr       Date:  2010 Nov-Dec       Impact factor: 4.016

3.  Nutrition therapy for the critically ill surgical patient: we need to do better!

Authors:  John W Drover; Naomi E Cahill; Jim Kutsogiannis; Giuseppe Pagliarello; Paul Wischmeyer; Miao Wang; Andrew G Day; Daren K Heyland
Journal:  JPEN J Parenter Enteral Nutr       Date:  2010 Nov-Dec       Impact factor: 4.016

4.  Impact of not measuring residual gastric volume in mechanically ventilated patients receiving early enteral feeding: a prospective before-after study.

Authors:  Fanny Poulard; Jerome Dimet; Laurent Martin-Lefevre; Frederic Bontemps; Maud Fiancette; Eva Clementi; Christine Lebert; Benoit Renard; Jean Reignier
Journal:  JPEN J Parenter Enteral Nutr       Date:  2009-10-27       Impact factor: 4.016

5.  Residents find clinical practice guidelines valuable as educational and clinical tools.

Authors:  A Helwig; D Bower; M Wolff; C Guse
Journal:  Fam Med       Date:  1998-06       Impact factor: 1.756

6.  Optimal amount of calories for critically ill patients: depends on how you slice the cake!

Authors:  Daren K Heyland; Naomi Cahill; Andrew G Day
Journal:  Crit Care Med       Date:  2011-12       Impact factor: 7.598

7.  Adequate Nutrition May Get You Home: Effect of Caloric/Protein Deficits on the Discharge Destination of Critically Ill Surgical Patients.

Authors:  D Dante Yeh; Eva Fuentes; Sadeq A Quraishi; Catrina Cropano; Haytham Kaafarani; Jarone Lee; David R King; Marc DeMoya; Peter Fagenholz; Kathryn Butler; Yuchiao Chang; George Velmahos
Journal:  JPEN J Parenter Enteral Nutr       Date:  2015-04-29       Impact factor: 4.016

8.  ESPEN Guidelines on Enteral Nutrition: Intensive care.

Authors:  K G Kreymann; M M Berger; N E P Deutz; M Hiesmayr; P Jolliet; G Kazandjiev; G Nitenberg; G van den Berghe; J Wernerman; C Ebner; W Hartl; C Heymann; C Spies
Journal:  Clin Nutr       Date:  2006-05-11       Impact factor: 7.324

9.  Nutrition support in the critical care setting: current practice in canadian ICUs--opportunities for improvement?

Authors:  Daren K Heyland; Deborah Schroter-Noppe; John W Drover; Minto Jain; Laurie Keefe; Rupinder Dhaliwal; Andrew Day
Journal:  JPEN J Parenter Enteral Nutr       Date:  2003 Jan-Feb       Impact factor: 4.016

Review 10.  The physiologic response and associated clinical benefits from provision of early enteral nutrition.

Authors:  Stephen A McClave; Daren K Heyland
Journal:  Nutr Clin Pract       Date:  2009 Jun-Jul       Impact factor: 3.080

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  2 in total

1.  Effectiveness of enteral feeding protocol on clinical outcomes in critically ill patients: A before and after study.

Authors:  Qian Li; Zhongheng Zhang; Bo Xie; Xiaowei Ji; Jiahong Lu; Ronglin Jiang; Shu Lei; Shihao Mao; Lijun Ying; Di Lu; Xiaoshui Si; Mingxia Ji; Jianxing He; Mengyan Chen; Wenjuan Zheng; Jiao Wang; Jing Huang; Junfeng Wang; Yaling Ji; Guodong Chen; Jianhua Zhu; Yadi Shao; Ronghai Lin; Chao Zhang; Weiwen Zhang; Jian Luo; Tianzheng Lou; Xuwei He; Kun Chen; Wei Peng; Renhua Sun
Journal:  PLoS One       Date:  2017-08-03       Impact factor: 3.240

2.  Studying the effect of abdominal massage on the gastric residual volume in patients hospitalized in intensive care units.

Authors:  Farzad Momenfar; Alireza Abdi; Nader Salari; Ali Soroush; Behzad Hemmatpour
Journal:  J Intensive Care       Date:  2018-08-10
  2 in total

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