Juho Nurkkala1, T Kaakinen2, M Vakkala2, T Ala-Kokko2, Janne H Liisanantti2. 1. University of Oulu, Medical Research Center, Research Group of Surgery, Anaesthesia and Intensive Care and Department of Anaesthesiology, Oulu University Hospital, Oulu, Finland. juho.nurkkala@student.oulu.fi. 2. University of Oulu, Medical Research Center, Research Group of Surgery, Anaesthesia and Intensive Care and Department of Anaesthesiology, Oulu University Hospital, Oulu, Finland.
Abstract
BACKGROUND: Discrepancy between prescribed and administered enteral nutrition (EN) is a common problem during intensive care. The aim of this study was to find out the success rate and factors associated with inadequacy of enteral nutrition in a mixed general intensive care unit (ICU). METHODS: This was a retrospective single-center study of 892 patients with ICU length of stay (LOS) ≥4 days. The factors associated with adequacy of enteral nutrition on day 4 were analyzed. These included disease-specific factors, patient-related factors, severity of illness, and procedural factors. RESULTS: Of the 892 patients, 349 (39.1%) had an EN success rate of ≥70%, which was associated with a lower amount of prescribed enteral energy (500 kcal [500-800] vs. 800 kcal [500-1200], p < 0.001) and bolus administration of enteral nutrition (41 of 349 vs. 27 of 543, p < 0.001). Other factors impairing successful EN were severe inflammation, surgery, and GI-related admission diagnosis. CONCLUSIONS: On the fourth day during ICU stay discrepancy between prescribed and administered enteral nutrition was associated to severe inflammation, GI-related diagnosis, and prescribing policy.
BACKGROUND: Discrepancy between prescribed and administered enteral nutrition (EN) is a common problem during intensive care. The aim of this study was to find out the success rate and factors associated with inadequacy of enteral nutrition in a mixed general intensive care unit (ICU). METHODS: This was a retrospective single-center study of 892 patients with ICU length of stay (LOS) ≥4 days. The factors associated with adequacy of enteral nutrition on day 4 were analyzed. These included disease-specific factors, patient-related factors, severity of illness, and procedural factors. RESULTS: Of the 892 patients, 349 (39.1%) had an EN success rate of ≥70%, which was associated with a lower amount of prescribed enteral energy (500 kcal [500-800] vs. 800 kcal [500-1200], p < 0.001) and bolus administration of enteral nutrition (41 of 349 vs. 27 of 543, p < 0.001). Other factors impairing successful EN were severe inflammation, surgery, and GI-related admission diagnosis. CONCLUSIONS: On the fourth day during ICU stay discrepancy between prescribed and administered enteral nutrition was associated to severe inflammation, GI-related diagnosis, and prescribing policy.