Nutrition of the critically ill patient and effects of implementing a nutritional support algorithm in ICU

Wøien, Hilde; Bjørk, Ida Torunn

doi:10.1111/j.1365-2702.2006.01262.x

Cited by 84 publications

(78 citation statements)

References 26 publications

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“…1,2,[11][12][13][14] In those studies, the main causes of feeding interruption were gastrointestinal intolerance (gastric reflux, vomiting, or diarrhea), interruption for medical procedures, problems with the feeding tube, and airway management (extubation). 4,11,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Our study showed similar results. Few studies 12,16,22,28 evaluated the risk factors, intrinsic to the patient or not, that may predispose patients to interruption of enteral nutrition.…”

Section: Discussionsupporting

confidence: 79%

“…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. Some factors that vary daily, such as doses of vasoactive and sedation drugs, have already been reported.…”

Section: Methodsmentioning

confidence: 99%

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Nurse to Bed Ratio and Nutrition Support in Critically Ill Patients

Honda

Freitas

Stanich

et al. 2013

American Journal of Critical Care

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Background Inadequate nutrition support is common among critically ill patients, and identification of risk factors for such inadequacy might help in improving nutrition support. Objective To determine how often daily calorie goals are met and the factors responsible for inadequate nutrition support. Methods A single-center prospective cohort study. Each patient's demographic and clinical characteristics, the need for ventilatory support, the use and dosage of medications, the number of nursing staff per bed, the time elapsed from admission to the intensive care unit until the effective start of enteral feeding, and the causes for nonadministration were recorded. Achievement of daily calorie goals was determined and correlated with risk factors. Results A total of 262 daily evaluations were done in 40 patients. Daily calorie goal was achieved in only 46.2% of the evaluations (n = 121), with a mean of 74.8% of the prescribed volume of enteral nutrition infused daily. Risk factors for inadequate nutrition support were the use of midazolam (odds ratio, 1.58; 95% CI, 1.18-2.11) and fewer nursing professionals per bed (odds ratio, 2.56; 95% CI, 1.43-4.57). Conclusion Achievement of daily calorie goals was inadequate, and the main factors associated with this failure were the use and dosage of midazolam and the number of nurses available.

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Section: Discussionsupporting

confidence: 79%

Section: Methodsmentioning

confidence: 99%

Nurse to Bed Ratio and Nutrition Support in Critically Ill Patients

Honda

Freitas

Stanich

et al. 2013

American Journal of Critical Care

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“…This appears to emphasize the importance of a precise determination of the energy target as well as the likelihood of achieving an improved nutritional status by using a nutritional algorithm that focused on achieving the target calorie intake within 3 days via full EN or immediate use of SPN, whenever EN fails to meet energy needs (3,31).…”

Section: Discussionmentioning

confidence: 99%

Importance of target calorie intake in hospitalized patients

Harmandar

Gömceli²,

Yolcular³

et al. 2020

Turk J Gastroenterol

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“…33,37 Specific determination of what constitutes a high GRV is unclear in the literature, and practices for assessing and addressing high GRVs vary. [38][39][40][41] Uncertainty regarding the assessment and treatment of high GRVs makes clinical decision making regarding management of GRVs difficult for practitioners.…”

Section: Intolerance Of Enteral Nutritionmentioning

confidence: 99%

Interruptions in Enteral Nutrition Delivery in Critically Ill Patients and Recommendations for Clinical Practice

Stewart

2014

Critical Care Nurse

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M alnutrition results when nutritional intake does not meet metabolic requirements. Critically ill patients are at an increased risk for malnutrition because of alterations in protein and energy metabolism displayed in response to trauma, major surgery, burns, and sepsis 1 and may be unable to tolerate oral nutrition. Critical care nurses are well positioned to screen patients at risk for malnutrition and to work in conjunction with the multidisciplinary team to develop and implement interventions to prevent and treat malnutrition. Interruptions in Enteral Nutrition Delivery in Critically Ill Patients and Recommendations for Clinical Practice MELISSA L. STEWART, RN, DNP, MSN, CCNS, CCRNThis article has been designated for CNE credit. A closed-book, multiple-choice examination follows this article, which tests your knowledge of the following objectives:1. List consequences of malnutrition in critically ill patients 2. Discuss how current nursing routines may contribute to interruptions in enteral nutrition in critically ill patients 3. Describe nursing interventions to improve the delivery of nutrition to critically ill patients CNE Continuing Nursing EducationCover Malnutrition is common in critically ill patients and is associated with poor outcomes for patients and increased health care spending. Enteral nutrition is the method of choice for nutrition delivery. Enteral nutrition delivery practices vary widely, and underfeeding is widespread in critical care. Interruptions in enteral nutrition due to performance of procedures, positioning, technical issues with feeding accesses, and gastrointestinal intolerance contribute to underfeeding. Strategies such as head-of-bed positioning, use of prokinetic agents, tolerance of higher gastric residual volumes, consideration of postpyloric feeding access, and use of a nutrition support protocol may decrease time spent without nutrition. (Critical Care Nurse.

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Nutrition of the critically ill patient and effects of implementing a nutritional support algorithm in ICU

Abstract: By using a nutritional algorithm focused on enteral nutrition, but including parenteral nutrition as a supplement, it is possible to improve the delivery of clinical nutrition in the intensive care unit patients.

Cited by 84 publications

References 26 publications

Nurse to Bed Ratio and Nutrition Support in Critically Ill Patients

Nurse to Bed Ratio and Nutrition Support in Critically Ill Patients

Importance of target calorie intake in hospitalized patients

Interruptions in Enteral Nutrition Delivery in Critically Ill Patients and Recommendations for Clinical Practice

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