A study of problems associated with the delivery of enteral feed in critically ill patients in five ICUs in the UK

Abstract

The major factors associated with the interruption in delivery of feed are problems with gut function and stopping feed prior to a procedure. Use of specific feeding protocols is clearly associated with a greater volume of feed delivered and a greater percentage of the prescription delivered. These should be an integral part of all ICU protocols.

Nurse to Bed Ratio and Nutrition Support in Critically Ill Patients

“…Those studies showed that training and further integration on a multidisciplinary team for nutritional therapy lead to better performance. 1,26,32,33 As this is an external risk factor that is reversible, our results might be useful for health care administrators in charge of the number of nursing staff.…”

“…The total calorie goal was 20 to 25 kcal/kg in the acute phase of injury and 25 to 30 kcal/kg during I nadequate intake of calories and protein is a common problem in intensive care units (ICUs) [1][2][3][4] and results from a combination of a hypercatabolic state and a reduction in the nutrient supply. 5,6 The reduced nutrient supply may be due to an underestimation of the amount of calories and protein needed [7][8][9][10] or to the difference between the number of calories prescribed and the number received.…”

“…The percentage of prescribed calories that is actually received varies between 51% and 99%. 1,2,[11][12][13][14] The main factors responsible for the interruption of enteral nutrition are gastrointestinal intolerance (gastric reflux, vomiting, or diarrhea), procedures or examinations, problems with the feeding tube, and airway management. 4,[14][15][16][17][18][19][20][21][22][23][24][25][26][27] However, most previous studies involved evaluation of whether or not patients met their nutrition goals during the entire ICU stay rather than on a daily basis.…”

Terapia nutricional enteral em politraumatizados sob ventilação mecânica e oferta energética

“…Alguns estudos relatam que a equação de Harris-Benedict, principalmente em pacientes críticos, poderia superestimar a necessidade energética, levando à superalimentação e a complicações metabólicas e respiratórias 11,18 . Por esse motivo, muitos profissionais optam por prescrever uma quantidade inferior de calorias e evoluir cuidadosamente a dieta.…”

“…A calorimetria indireta é considerada o método mais preciso para a determinação das necessidades energéticas dos pacientes sob VM 11 . Entretanto, esse método também apresenta limitações por depender de um monitor de gases e por apresentar dificuldade de aplicação em casos de pacientes críticos que se encontram em instabilidade hemodinâmica 38 .…”