Factors associated with discrepancy between prescribed and administered enteral nutrition in general ICU

Nurkkala, Juho; Kaakinen, Timo; Vakkala, Merja; Ala‐Kokko, Tero; Liisanantti, Janne

doi:10.1038/s41430-019-0451-8

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…Special emphasis should be put to avoiding and mitigating ileus and efforts should be made to improve appetite. For patients whose nutrition is commenced mainly or solely by nutritional support, regular central venous catheter insertion, closer monitoring of nutrition delivery and utilization of multidisciplinary nutrition teams might improve the adequacy of nutritional support in this patient group [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Nutrition delivery after emergency laparotomy in surgical ward: a retrospective cohort study

Nurkkala

Lahtinen

Ylimartimo

et al. 2021

Eur J Trauma Emerg Surg

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Purpose Adequate nutrition after major abdominal surgery is associated with less postoperative complications and shorter hospital length of stay (LOS) after elective procedures, but there is a lack of studies focusing on the adequacy of nutrition after emergency laparotomies (EL). The aim of the present study was to investigate nutrition adequacy after EL in surgical ward. Methods The data from 405 adult patients who had undergone emergency laparotomy in Oulu University Hospital (OUH) between years 2015 and 2017 were analyzed retrospectively. Nutrition delivery and complications during first 10 days after the operation were evaluated. Results There was a total of 218 (53.8%) patients who were able to reach cumulative 80% nutrition adequacy during the first 10 postoperative days. Patients with adequate nutrition (> 80% of calculated calories) met the nutritional goals by the second postoperative day, whereas patients with low nutrition delivery (< 80% of calculated calories) increased their caloric intake during the first 5 postoperative days without reaching the 80% level. In multivariate analysis, postoperative ileus [4.31 (2.15–8.62), P < 0.001], loss of appetite [3.59 (2.18–5.93), P < 0.001] and higher individual energy demand [1.004 (1.003–1.006), P = 0.001] were associated with not reaching the 80% nutrition adequacy. Conclusions Inadequate nutrition delivery is common during the immediate postoperative period after EL. Oral nutrition is the most efficient way to commence nutrition in this patient group in surgical ward. Nutritional support should be closely monitored for those patients unable to eat. Trial registration number Not applicable.

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Section: Discussionmentioning

confidence: 99%

Nutrition delivery after emergency laparotomy in surgical ward: a retrospective cohort study

Nurkkala

Lahtinen

Ylimartimo

et al. 2021

Eur J Trauma Emerg Surg

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“…In the intensive care setting, it has been reported that nutrition adequacy can be as low as 30% of calculated demand when feeding is conducted solely by nutrition support [22]. The impact of nutrition support has become more evident in the intensive care by the introduction of nutrition support protocols, inspecting the patient's nutritional status twice a day and by including a routine dietician consultation for every patient [16,23]. These methods could also be utilized in HNC patients to enhance nutrition support.…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative surgical site infections were more frequent in patients with impaired nutrition adequacy in the present study. It has been reported that postoperative malnutrition in surgical and intensive care patients predisposes to infectious complications [1,2,10,16,23]. On the other hand, it is known that postoperative surgical site infections are a risk factor to reoperations [9], which may predispose to malnutrition caused by preoperative fasting.…”

Section: Discussionmentioning

confidence: 99%

“…This could be attained by adequate pain medication and by utilizing consultation of a dietician and a physiotherapist in the immediate recovery phase [10]. For patients whose oral food intake is insufficient, nutrition support delivery could be increased by using specified nutrition protocols and by inspecting the nutritional status twice a day [1,23]. A multidisciplinary team (surgeon, physiotherapist, dietician, trained nurse) could be very useful in establishing and enhancing individual nutritional support for patients after HNC free flap surgery as well as after any major surgery [10].…”

Section: Clinical Significancementioning

confidence: 99%

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Causes of nutrition deficit during immediate postoperative period after free flap surgery for cancer of the head and neck

Nurkkala

Lahtinen

Kaakinen

et al. 2020

Eur Arch Otorhinolaryngol

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The aim of the present of study was to examine nutrition deficit during the immediate postoperative in-hospital period following free flap surgery for cancer of the head and neck (HNC). Underfeeding and malnutrition are known to be associated with impaired short-and long-time recovery after major surgery. Methods This single-center retrospective cohort study included 218 HNC patients who underwent free flap surgery in Oulu University Hospital, Finland between the years 2008 and 2018. Nutrition delivery methods, the adequacy of nutrition and complication rates were evaluated during the first 10 postoperative days. Results A total of 131 (60.1%) patients reached nutritional adequacy of 60% of calculated individual demand during the follow-up period. According to multivariate analysis, nutrition inadequacy was associated with higher ideal body weight (OR 1.11 [1.04-1.20]), whereas adequate nutrition was associated with higher number of days with oral food intake (OR 0.79 [0.67-0.93]). Conclusion Inadequate nutrition is common after HNC free flap surgery. The present results suggest that more adequate nutrition delivery might be obtained by the early initiation of oral food intake and close monitoring of nutrition support.

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Dynamic assessment of prealbumin for nutrition support effectiveness in critically ill patients

Pardo,

Jabaudon,

Godet

et al. 2024

Clinical Nutrition

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Factors associated with discrepancy between prescribed and administered enteral nutrition in general ICU

Cited by 5 publications

References 15 publications

Nutrition delivery after emergency laparotomy in surgical ward: a retrospective cohort study

Nutrition delivery after emergency laparotomy in surgical ward: a retrospective cohort study

Causes of nutrition deficit during immediate postoperative period after free flap surgery for cancer of the head and neck

Dynamic assessment of prealbumin for nutrition support effectiveness in critically ill patients

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