Bangchuan Hu1, Renhua Sun1, Aiping Wu1, Yin Ni1, Jingquan Liu1, Feng Guo2, Lijun Ying3, Guoping Ge4, Aijun Ding5, Yunchao Shi6, Changwen Liu7, Lei Xu8, Ronglin Jiang9, Jun Lu10, Ronghai Lin11, Yannan Zhu12, Weidong Wu13, Bo Xie14. 1. ICU, Zhejiang Provincial People's Hospital, Hangzhou, P. R. China. 2. ICU, Sir Run Shaw Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China. 3. ICU, Shaoxing People's Hospital, Shaoxing, P. R. China. 4. ICU, Jinhua People's Hospital, Jinhua, P. R. China. 5. ICU, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, P. R. China. 6. ICU, The First Hospital of Jiaxing, Jiaxing, P. R. China. 7. ICU, Hangzhou First People's Hospital, Hangzhou, P. R. China. 8. ICU, Ningbo Medical Treatment Center Lihuili Hospital, Ningbo, P. R. China. 9. ICU, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, P. R. China. 10. ICU, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, P. R. China. 11. ICU, Taizhou Hospital of Zhejiang Province, Linhai, P. R. China. 12. ICU, Zhuji People's Hospital of Zhejiang Province, Shaoxing, P. R. China. 13. ICU, The Central Hospital of Lishui City, Lishui, P. R. China. 14. ICU, Huzhou Central Hospital, Huzhou, P. R. China.
Abstract
BACKGROUND: The 2012 European Society of Intensive Care Medicine (ESICM) guidelines provided a clear definition of feeding intolerance (FI). The study aimed to investigate the association between FI based on the current ESICM definition and clinical outcome and to further explore the effect of the duration of FI on mortality. METHODS: Adult patients from 14 general intensive care units (ICUs) with an expected ICU stay ≥24 hours were prospectively studied. Based on FI duration in the first week of admission to the ICU, FI was categorized as 7-day persistent feeding tolerance (FT), delayed FT, delayed FI, and 7-day persistent FI. The primary outcomes were 28-day and 60-day all-cause mortality. RESULTS: Of 499 patients, the prevalence of 3-day and 7-day persistent FI was 39.2% (n = 196) and 25.4% (n = 106), respectively. The patients with 3-day FT had lower risk of 28-day and 60-day mortality rates and higher prevalence in ventilator weaning and vasoactive medication on the seventh day of ICU admission than those with 3-day FI. Three-day FI remained an independent predictor for 60-day mortality. In a subgroup analysis including 418 patients with 7-day survival, compared with those with 7-day persistent FT, the odds ratios of 60-day mortality were 1.67, 1.97, and 2.62 in the patients with delayed FT, delayed FI, and 7-day persistent FI, respectively. CONCLUSION: FI was associated with increased mortality and longer duration of mechanical ventilation and vasoactive support. Prolonged or relapsing FI represented an incremental risk of adverse outcomes in critically ill patients.
BACKGROUND: The 2012 European Society of Intensive Care Medicine (ESICM) guidelines provided a clear definition of feeding intolerance (FI). The study aimed to investigate the association between FI based on the current ESICM definition and clinical outcome and to further explore the effect of the duration of FI on mortality. METHODS: Adult patients from 14 general intensive care units (ICUs) with an expected ICU stay ≥24 hours were prospectively studied. Based on FI duration in the first week of admission to the ICU, FI was categorized as 7-day persistent feeding tolerance (FT), delayed FT, delayed FI, and 7-day persistent FI. The primary outcomes were 28-day and 60-day all-cause mortality. RESULTS: Of 499 patients, the prevalence of 3-day and 7-day persistent FI was 39.2% (n = 196) and 25.4% (n = 106), respectively. The patients with 3-day FT had lower risk of 28-day and 60-day mortality rates and higher prevalence in ventilator weaning and vasoactive medication on the seventh day of ICU admission than those with 3-day FI. Three-day FI remained an independent predictor for 60-day mortality. In a subgroup analysis including 418 patients with 7-day survival, compared with those with 7-day persistent FT, the odds ratios of 60-day mortality were 1.67, 1.97, and 2.62 in the patients with delayed FT, delayed FI, and 7-day persistent FI, respectively. CONCLUSION: FI was associated with increased mortality and longer duration of mechanical ventilation and vasoactive support. Prolonged or relapsing FI represented an incremental risk of adverse outcomes in critically illpatients.