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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

References

    1. Kreymann KG, Berger MM, Deutz NE, Hiesmayr M, Jolliet P, Kazandjiev G, et al. ESPEN Guidelines on Enteral Nutrition: Intensive care. Clin Nutr. 2006;25:210–23. - PubMed
    1. Cerra FB, Benitez MR, Blackburn GL, Irwin RS, Jeejeebhoy K, Katz DP, et al. Applied nutrition in ICU patients. A consensus statement of the American College of Chest Physicians. Chest. 1997;111:769–78. - PubMed
    1. Braunschweig CL, Levy P, Sheean PM, Wang X. Enteral compared with parenteral nutrition: A meta-analysis. Am J Clin Nutr. 2001;74:534–42. - PubMed
    1. Peter JV, Moran JL, Phillips-Hughes J. A metaanalysis of treatment outcomes of early enteral versus early parenteral nutrition in hospitalized patients. Crit Care Med. 2005;33:213–20. - PubMed
    1. Simpson F, Doig GS. Parenteral vs. enteral nutrition in the critically ill patient: A meta-analysis of trials using the intention to treat principle. Intensive Care Med. 2005;31:12–23. - PubMed