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. 2014 Mar;18(3):144-8.
doi: 10.4103/0972-5229.128704.

Critical care 24 × 7: But, why is critical nutrition interrupted?

Nagarajan Ramakrishnan  1 , D K Daphnee  2 , Lakshmi Ranganathan  1 , S Bhuvaneshwari  2
Affiliations

Critical care 24 × 7: But, why is critical nutrition interrupted?

Nagarajan Ramakrishnan et al. Indian J Crit Care Med. 2014 Mar.

Abstract

Background and aims: Adequate nutritional support is crucial in prevention and treatment of malnutrition in critically ill-patients. Despite the intention to provide appropriate enteral nutrition (EN), meeting the full nutritional requirements can be a challenge due to interruptions. This study was undertaken to determine the cause and duration of interruptions in EN.

Materials and methods: Patients admitted to a multidisciplinary critical care unit (CCU) of a tertiary care hospital from September 2010 to January 2011 and who received EN for a period >24 h were included in this observational, prospective study. A total of 327 patients were included, for a total of 857 patient-days. Reasons and duration of EN interruptions were recorded and categorized under four groups-procedures inside CCU, procedures outside CCU, gastrointestinal (GI) symptoms and others.

Results: Procedure inside CCU accounted for 55.9% of the interruptions while GI symptoms for 24.2%. Although it is commonly perceived that procedures outside CCU are the most common reason for interruption, this contributed only to 18.4% individually; ventilation-related procedures were the most frequent cause (40.25%), followed by nasogastric tube aspirations (15.28%). Although GI bleed is often considered a reason to hold enteral feed, it was one of the least common reasons (1%) in our study. Interruption of 2-6 h was more frequent (43%) and most of this (67.1%) was related to "procedures inside CCU".

Conclusion: Awareness of reasons for EN interruptions will aid to modify protocol and minimize interruptions during procedures in CCU to reach nutrition goals.

Keywords: Critical care; enteral nutrition; interruption of feeds; malnutrition.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Hours enteral feed interrupted
Figure 2
Figure 2
Enteral nutrition interruptions due to gastrointestinal symptoms
See this image and copyright information in PMC

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