Evaluation of current feeding practices in the critically ill: A retrospective chart review

Stewart, Melissa Lottes; Biddle, Martha J; Thomas, Travis

doi:10.1016/j.iccn.2016.05.004

Cited by 24 publications

(33 citation statements)

References 34 publications

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“…A retrospective U.S. audit recorded protein adequacy from EN at day 3 of ICU admission, providing a similar comparison with day 1-3 delivery in the current audit. 17 Protein adequacy was only 17% for the U.S. sample of mostly medical ICU patients. 17 The current audit was at a major trauma center, and therefore included a large proportion of trauma and neurosurgery patients.…”

Section: Discussionmentioning

confidence: 96%

“…17 Protein adequacy was only 17% for the U.S. sample of mostly medical ICU patients. 17 The current audit was at a major trauma center, and therefore included a large proportion of trauma and neurosurgery patients. In the U.S. audit, only 9% of patients audited received ࣙ80% of their protein prescription on day 3, compared with 22% of patients in the current audit who received 100% of their protein target based on local guidelines, on day 1-3 of ICU admission.…”

Section: Discussionmentioning

confidence: 96%

“…In the U.S. audit, only 9% of patients audited received ࣙ80% of their protein prescription on day 3, compared with 22% of patients in the current audit who received 100% of their protein target based on local guidelines, on day 1-3 of ICU admission. 17 Prospective cohort studies carried out in the Netherlands reported a higher proportion of patients achieving their protein target with EN delivery. 6,29 Weijs et al 6 reported that 30% of patients achieved at least 1.2 g/kg/d during the period of mechanical ventilation when targets were set at 1.2-1.5 g/kg/d.…”

Section: Discussionmentioning

confidence: 99%

“…There is a large deficit between protein guidelines vs prescription, 14 and enteral/parenteral protein prescription vs delivery in intensive care units (ICUs) worldwide. [15][16][17] In a previous audit in the study ICU, only 19% of enteral protein prescriptions met local guidelines. 14 It was shown that, in theory, use of protein supplements and adjustment of protein prescriptions for NNE could significantly increase the proportion of patients meeting protein guidelines.…”

Section: Introductionmentioning

confidence: 91%

“…There is a large deficit between protein guidelines vs prescription, and enteral/parenteral protein prescription vs delivery in intensive care units (ICUs) worldwide . In a previous audit in the study ICU, only 19% of enteral protein prescriptions met local guidelines .…”

Section: Introductionmentioning

confidence: 99%

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Protein Provision in Critically Ill Adults Requiring Enteral Nutrition: Are Guidelines Being Met?

et al. 2018

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Background In a previous audit, 81% of enteral protein prescriptions failed to meet protein guidelines. To address this, a very high‐protein enteral formula and protein supplements were introduced, and protein prescriptions were adjusted to account for nonnutrition energy sources displacing enteral formula. This follow‐up audit compared protein provision in critically ill adults requiring exclusive enteral nutrition (EN), first, with local and international guidelines, and second, after changes to practice, with the previous audit in the same intensive care unit (ICU). Methods Data were collected from 106 adults consecutively admitted to the ICU of a U.K. tertiary hospital and requiring exclusive EN ≥3 days. Protein targets based on local guidelines (1.25, 1.5, or 2.0 g/kg/d), nutrition prescription, and delivery were recorded for 24 hours between days 1–3, 5–7, 8–10, and 18–20 post‐ICU admission. Results The proportion of day 1–3 protein prescriptions meeting protein targets increased from 19% in 2015 to 69% in 2017 (P < .0005, φ = 0.50). The median percentage of protein target delivered was lower than prescribed (79% vs 103%; (P < .0005; r = 0.53) and EN delivery only met the target of 22% of patients. The proportion of protein prescriptions meeting protein targets was similar for days 1–3 (69%), 5–7 (71%), and 8–10 (68%), but increased slightly by days 18–20 (74%). The proportion of patients for which EN delivery met protein targets increased with the number of days post‐ICU admission (22%, 26%, 37%, and 53% for days 1–3, 5–7, 8–10, and 18–20, respectively). Conclusion The proportion of protein prescriptions meeting guideline targets was higher after changes to practice.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Protein Provision in Critically Ill Adults Requiring Enteral Nutrition: Are Guidelines Being Met?

et al. 2018

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Determination of calorie and protein intake among acute and sub-acute traumatic brain injury patients

Abdullah

Ahmad

Wafa

et al. 2020

Chinese Journal of Traumatology

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Purpose Malnutrition is a common problem among hospitalized patients, especially among traumatic brain injury (TBI) patients. It is developed from hypermetabolism and the condition may worsen under the circumstance of underfeeding or incompatible dietary management. However, the data of nutrient intake especially calorie and protein among TBI patients were scarce. Hence, this study aimed to determine the calorie and protein intake among acute and sub-acute TBI patients receiving medical nutrition therapy in hospital Sultanah Nur Zahirah, Terengganu. Methods This observational study involved 50 patients recruited from the neurosurgical ward. Method of 24 h dietary recall was utilized and combined with self-administered food diaries for 2–8 days. Food consumptions including calorie intake and protein intake were analyzed using Nutritionist PRO™ (Woodinville, USA) and manual calculation based on the Malaysian food composition database (2015). Results Patients consisted of 56% males and 44% females with the median age of 28.0 (IQR = 22.8-36.5) years, of which 92% were diagnosed as mild TBI and the remaining (8%) as moderate TBI. The Glasgow coma scale (GCS) was adopted to classify TBI severity with the score 13–15 being mild and 9–12 being moderate. The median length of hospital stay was 2 (IQR = 2.0–3.3) days. Calorie and protein intake improved significantly from day 1 to discharge day. However, the intake during discharge day was still considered as suboptimal, i.e. 75% of calorie requirement, whilst the median protein intake was only 61.3% relative to protein requirement. Moreover, the average percentages of calorie and protein intakes throughout hospitalization were remarkably lower, i.e. 52.2% and 41.0%, respectively. Conclusion Although the calorie and protein intakes had increased from baseline, hospitalized TBI patients were still at a risk to develop malnutrition as the average intakes were considerably low as compared to their requirements. Optimum nutrient intakes especially calorie and protein are crucial to ensure optimum recovery process as well as to minimize risks of infection and complications.

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Use of standard enteral formula versus enteric formula with prebiotic content in nutrition therapy: A randomized controlled study among neuro-critical care patients

Tuncay

Arpaci

Doğanay

et al. 2018

Clinical Nutrition ESPEN

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Evaluation of current feeding practices in the critically ill: A retrospective chart review

Cited by 24 publications

References 34 publications

Protein Provision in Critically Ill Adults Requiring Enteral Nutrition: Are Guidelines Being Met?

Protein Provision in Critically Ill Adults Requiring Enteral Nutrition: Are Guidelines Being Met?

Determination of calorie and protein intake among acute and sub-acute traumatic brain injury patients

Use of standard enteral formula versus enteric formula with prebiotic content in nutrition therapy: A randomized controlled study among neuro-critical care patients

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