Volume-based feeding improves nutritional adequacy in surgical patients

Krebs, Elizabeth D.; O’Donnell, Kelly; Berry, Amy; Guidry, Christopher A.; Hassinger, Taryn E.; Sawyer, Robert G.

doi:10.1016/j.amjsurg.2018.05.016

Cited by 10 publications

(7 citation statements)

References 29 publications

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“…Energy and protein needs [7, 28-30, 32, 54, 55] 24. Total calories offered and ingested by the patient [7,9,20,[28][29][30][31][32][54][55][56] 25. Use of glutamine and oxandrolone [9,20] 26.…”

Section: Table 2 Process Quality Indicatorsmentioning

confidence: 99%

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Quality indicators for hospital burn care: a scoping review

Suzuki,

Santana,

Ávila

et al. 2024

BMC Health Serv Res

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Background Burn treatments are complex, and for this reason, a specialised multidisciplinary approach is recommended. Evaluating the quality of care provided to acute burn patients through quality indicators makes it possible to develop and implement measures aiming at better results. There is a lack of information on which indicators to evaluate care in burn patients. The purpose of this scoping review was to identify a list of quality indicators used to evaluate the quality of hospital care provided to acute burn patients and indicate possible aspects of care that do not have specific indicators in the literature. Method A comprehensive scoping review (PRISMA-ScR) was conducted in four databases (PubMed, Cochrane Library, Embase, and Lilacs/VHL) between July 25 and 30, 2022 and redone on October 6, 2022. Potentially relevant articles were evaluated for eligibility. General data and the identified quality indicators were collected for each included article. Each indicator was classified as a structure, process, or outcome indicator. Results A total of 1548 studies were identified, 82 were included, and their reference lists were searched, adding 19 more publications. Thus, data were collected from 101 studies. This review identified eight structure quality indicators, 72 process indicators, and 19 outcome indicators listed and subdivided according to their objectives. Conclusion This study obtained a list of quality indicators already used to monitor and evaluate the hospital care of acute burn patients. These indicators may be useful for further research or implementation in quality improvement programs. Trial Registration Protocol was registered on the Open Science Framework platform on June 27, 2022 (https://doi.org/10.17605/OSF.IO/NAW85).

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Section: Table 2 Process Quality Indicatorsmentioning

confidence: 99%

“…Positive blood cultures and pathogen identification [2,18] 50. Incidence of healthcare-associated infections [7,9,18,20,35,40,52,53,56,58,59,63,66,68,[73][74][75][76][77][78] 51. Incidence and duration of sepsis [7,19,52,62,66,74] 52.…”

Section: Table 2 Process Quality Indicatorsmentioning

confidence: 99%

Quality indicators for hospital burn care: a scoping review

Suzuki,

Santana,

Ávila

et al. 2024

BMC Health Serv Res

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“…Although many studies are published on the efficacy and safety of VBF in the medical ICU [10,11], well designed studies in patients with severe trauma are lacking. Although unique surgical requirements or pathophysiological characteristics of severe trauma patients, such as damage control surgery or temporary abdominal closure, can create a potentially unsuitable environment, enteral feeding is an important…”

Section: Comparison With Previous Studiesmentioning

confidence: 99%

Comparison of a volume-based feeding protocol with standard feeding for trauma patients in intensive care units in Korea: a retrospective cohort study

Park

Kwon

et al. 2023

Ann Clin Nutr Metab

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Purpose: Although early enteral nutrition for critically ill patients is essential, it is difficult to provide enteral nutrition to trauma patients in early hospitalization stages due to frequent surgeries and examinations. We aimed to identify the effect of achieving early enteral nutrition goals and improving outcomes through a volume-based feeding (VBF) protocol for trauma patients. Methods: Patients who were admitted to the trauma intensive care units (TICUs) of the Ajou University Hospital from January 2020 to September 2021 and received enteral tube feeding for at least 7 days were studied. An institutionspecific VBF protocol was developed, and nurses were trained in its execution. We retrospectively compared outcomes, such as in-hospital mortality and initial nutritional goal achievement, between the new and standard protocols. Results: Among 2,935 patients, 109 met the inclusion criteria. Of these, 64 patients received nutrition through VBF, with no feeding intolerance symptoms. The VBF group started enteral nutrition approximately 16.9 hours earlier and group achieved 80% of the target calorie and protein intake approximately one day faster than the control group (n=45). The average calorie supply per body weight per day was 4.9 kcal/kg/day more in the VBF group. An increase of 0.2 g/ kg/day was also observed in protein uptake. However, mortality and adverse hospital events did not differ between the groups. Conclusion:The VBF protocol for patients admitted to the TICU increased the initial nutrient supply without risk of feeding intolerance, but there was no improvement in major clinical outcomes, including mortality and adverse hospital events.

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“…The good news is that by adjusting binary thinking to a more inclusive and spectrum‐based approach, and by redirecting the follow‐up action from “doing vs not doing it” to “when should we consider this” or “how can we approach it differently,” it leads to new ideas and opens new chapters. For example, the decade‐old debate on “should we or should we not check gastric residual volume in ICU patients” has been a distraction of the real question, which is “how are we meeting the nutrition needs of our patients?” A change from the binary thinking to a more open‐ended approach leads to the current focus on volume‐based vs the conventional rate‐based enteral feeding 48–57 . Similarly, Professor Mette Berger, the recipient of the ASPEN Rhoads Research award this year, has showed that an antioxidant cocktail containing zinc, selenium, vitamin C, and vitamin E appears to demonstrate no benefit in reducing hospital length of stay in all patients.…”

Section: Scientific Processmentioning

confidence: 99%

“…A change from the binary thinking to a more open-ended approach leads to the current focus on volume-based vs the conventional rate-based enteral feeding. [48][49][50][51][52][53][54][55][56][57] Similarly, Professor Mette Berger, the recipient of the ASPEN Rhoads Research award this year, has showed that an antioxidant cocktail containing zinc, selenium, vitamin C, and vitamin E appears to demonstrate no benefit in reducing hospital length of stay in all patients. But if we change the binary thinking, yes vs no approach, and rephrase the question as "who may benefit from this therapy?"…”

Section: Theme 2: Apply Nonbinary Thinkingmentioning

confidence: 99%

Forty‐Fourth ASPEN Presidential Address: The 2020 Overture—A New Tune for the Future

Chan

2020

J Parenter Enteral Nutr

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The provision of safe nutrition care to patients is the fundamental vision of the American Society for Parenteral and Enteral Nutrition (ASPEN). Yet we are facing important challenges in our field and society, requiring us to reflect, rethink, and adjust to make new breakthroughs to meet the needs for the future. In developing new plans to address these challenges, we must focus on 2 critical elements: people and the scientific process. Government and organizations cannot carry on their missions without people. But with the challenges of healthcare finance, biotechnology disruption, the desire to facilitate knowledge transfer and now the impact of the global pandemic, we need to develop a forward‐thinking and sustainable approach to connect people and foster continued learning. Burnout is a recognized occupational problem that affects providers and researchers across all disciplines. The coronavirus disease 2019 pandemic has amplified the challenges associated with burnout. Supporting the needs and promoting the well‐being of people, therefore, are critical to move forward successfully. At the same time, the scientific advances in our field rely on sound scientific principles and integrity. Information overload, pressure to produce immediate outcomes (such as cost‐saving initiatives), and misinformation can compromise the scientific process and research evidence. The two common missteps that affect researchers, clinicians, and administrators include premature factulation and binary thinking. We will discuss how these missteps can occur and the approaches to minimize their influence in making sound decisions and policies to meet the future's needs.

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Volume-based feeding improves nutritional adequacy in surgical patients

Cited by 10 publications

References 29 publications

Quality indicators for hospital burn care: a scoping review

Quality indicators for hospital burn care: a scoping review

Comparison of a volume-based feeding protocol with standard feeding for trauma patients in intensive care units in Korea: a retrospective cohort study

Forty‐Fourth ASPEN Presidential Address: The 2020 Overture—A New Tune for the Future

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