No abstract

No abstract

BackgroundInadequate delivery of nutrition in critically ill patients has been shown to have adverse outcomes. A surgical trauma intensive care unit provides unique challenges to enteral feeds. Although volume‐based feeding protocols, like Enhanced Protein‐Energy Provision via the Enteral Route Feeding Protocol (PEP uP), have been successfully used in medical intensive care patients, data are sparse on its safety and efficacy in a surgical intensive care unit population.MethodsA PEP uP protocol was recently initiated at our American College of Surgeons Level 1 verified trauma center. Medical records of 197 patients before this change (pre‐PEP uP) were compared with 295 patients after this change (post‐PEP uP).ResultsThe post‐PEP uP group met/exceeded energy goals (defined as 80% of target) more often (57.0% compared with 26.9%, P‐value < .001), with an adjusted odds ratio (OR) of 4.98 (95% CI 3.49‐7.10), and more often met/exceeded protein goals (57.4% compared with 18.6%, P‐value < .001), with an adjusted OR of 11.84 (95% CI 7.94‐17.64). There was no significant difference in emesis during this time. Additionally, patients in the post‐PEP uP arm had less episodes of hyperglycemia (9% compared with 14.4%, P‐value < .001).ConclusionsVolume‐based feeding protocols like PEP uP are safe in critically ill trauma patients and are more effective at delivering energy and protein while limiting hyperglycemic episodes when compared with a traditional delivery method.

No abstract