The implementation of a nutrition protocol in a surgical intensive care unit; a randomized controlled trial at a tertiary care hospital

Chinda, Pornrat; Poomthong, Pulyamon; To-adithep, Puriwat; Thanakiattiwibun, Chayanan; Chaiwat, Onuma

doi:10.1371/journal.pone.0231777

Cited by 3 publications

(3 citation statements)

References 20 publications

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“…Auiwattanakul et al conducted a study on 1,686 surgical ICU patients in Thailand and reported that patients reached their calorie goal after 7–10 days [ 48 ]. Another study on 170 surgical ICU patients in Thailand found that less than 40% of the patients reached 60% of their target calories absorption by the fourth day in the ICU [ 49 ]. The tendency of developing feeding intolerance and decreased calorie absorption as a result of ICU stays is a common observation that may impair the patient outcome.…”

Section: Discussionmentioning

confidence: 99%

Digestion-Specific Acupuncture Effect on Feeding Intolerance in Critically Ill Post-Operative Oral and Hypopharyngeal Cancer Patients: A Single-Blind Randomized Control Trial

et al. 2021

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Malnourishment is prevalent in patients suffering from head and neck cancer. The postoperative period is crucial in terms of nutritional support, especially after composite resection and reconstruction surgery. These patients present with a number of risk factors that aggravate feeding intolerance, including postoperative status, prolonged immobility, decreased head elevation, mechanical ventilation, and applied sedative agents. Routine management protocols for feeding intolerance include prokinetic drug use and post-pyloric tube insertion, which could be both limited and accompanied by detrimental adverse events. This single-blind clinical trial aimed to investigate the effects of acupuncture in postoperative feeding intolerance in critically ill oral and hypopharyngeal cancer patients. Twenty-eight patients were randomized into two groups: Intervention group and Control group. Interventions were administered daily over three consecutive postoperative days. The primary outcome revealed that the intervention group reached 70% and 80% of target energy expenditure (EE) significantly earlier than the control group (4.00 ± 1.22 versus 6.69 ± 3.50 days, p = 0.012), accompanied by higher total calorie intake within the first postoperative week (10263.62 ± 1086.11 kcals versus 8384.69 ± 2120.05 kcals, p = 0.004). Furthermore, the intervention group also needed less of the prokinetic drug (Metoclopramide, 20.77 ± 48.73 mg versus 68.46 ± 66.56 mg, p = 0.010). In conclusion, digestion-specific acupuncture facilitated reduced postoperative feeding intolerance in oral and hypopharyngeal cancer patients.

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Section: Discussionmentioning

confidence: 99%

Digestion-Specific Acupuncture Effect on Feeding Intolerance in Critically Ill Post-Operative Oral and Hypopharyngeal Cancer Patients: A Single-Blind Randomized Control Trial

et al. 2021

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“…Although EN was performed in the ICU, more than 50% of the patients had to pause EN because of excessive GRV, diarrhea, aspiration, or repeated surgery or procedure, which limit use of EN in critically ill patients [13,14]. For better course of EN, every hospital should implement an EN protocol [15,16].…”

Section: Annals Of Clinical Nutrition and Metabolismmentioning

confidence: 99%

Provision of Enteral Nutrition in the Surgical Intensive Care Unit: A Multicenter Prospective Observational Study

Park

Lee

Hong

et al. 2022

Ann Clin Nutr Metab

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Purpose: Timely enteral nutrition (EN) is important in critically ill patients. However, use of EN with critically ill surgical patients has many limitations. This study aimed to analyze the current status of EN in surgical intensive care units (ICUs) in South Korea. Materials and Methods: A multicenter, prospective, observational study was conducted on patients who received EN in surgical ICUs at four university hospitals between August 2021 and January 2022. Results: This study included 125 patients. The mean time to start EN after admission to the surgical ICU was 6.2±4.6 days. EN was provided to 34 (27.2%) patients within 3 days after ICU admission. At 15.7±15.9 days, the target caloric requirement was achieved by 74 (59.2%) patients through EN alone. Furthermore, 104 (83.2%) patients received supplemental parenteral nutrition after a mean of 3.5±2.1 days. Only one of the four hospitals regularly used enteral feeding tubes and post-pyloric feeding tubes. Conclusion:Establishing EN guidelines for critically ill surgical patients and setting an appropriate insurance fee for EN-related devices, such as the feeding pump and enteral feeding tube, are necessary.

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“…(Phillips et al, 2017). The skeletal muscle wasting and weakness are more common associated with a prolonged need for mechanical ventilation; therefore, adequate nutrition therapy is important as an integral part in the treatment of critically ill patients (Chinda et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Comparative study between the effect of intermittent and hospital blended enteral feeding on intensive care patients’ outcomes

EL-Aziz

Mahgoub

Abbas

et al. 2020

Egyptian Journal of Health Care

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Background: Patients treated in the intensive care unit require enteral feedings to maintain adequate nutrition during critical illness. Aim of the study: to compare the effect of intermittent enteral feeding by using syringe pump versus hospital blended formula by using feeding bag on patients' outcomes. Setting: was carried out in three settings at Assiut university hospital. Sample: A randomized controlled experimental study in which seventy patients were selected by convenience sampling and assigned into two equal groups (35 patients each). Both groups received 2000 ml of feed per day and the same formula per day which was 30-35ml/kg of water, 1.5 g/kg of protein. The only manipulation was in the flow rate and the device by which the feed was administered. Tools: The three tools used in this study were developed by the researcher based on reviewing of the literatures. The first tool was general assessment sheet, the second tool is the feeding assessment sheet, The third tool is Patients' outcomes evaluation sheet Results: There were significant statistical differences between the outcomes of the two groups. The complications in the intermittent enteral feeding group were lower than those in feeding bag group as in gastrointestinal (P<0.001), mechanical (P=0.033) and metabolic complication (P0.005). Conclusion: intermittent enteral feeding by using syringe pump is extremely effective in reducing complications and improving the nutritional status among ICU patients. Recommendations: Intermittent enteral feeding should be used as a standard enteral feeding for patients in the ICU.

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The implementation of a nutrition protocol in a surgical intensive care unit; a randomized controlled trial at a tertiary care hospital

Cited by 3 publications

References 20 publications

Digestion-Specific Acupuncture Effect on Feeding Intolerance in Critically Ill Post-Operative Oral and Hypopharyngeal Cancer Patients: A Single-Blind Randomized Control Trial

Digestion-Specific Acupuncture Effect on Feeding Intolerance in Critically Ill Post-Operative Oral and Hypopharyngeal Cancer Patients: A Single-Blind Randomized Control Trial

Provision of Enteral Nutrition in the Surgical Intensive Care Unit: A Multicenter Prospective Observational Study

Comparative study between the effect of intermittent and hospital blended enteral feeding on intensive care patients’ outcomes

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