Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan, Malaysia.
Anaesthesiology Unit, Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan, Malaysia.
Nutrition. 2018 Sep;53:26-33. doi: 10.1016/j.nut.2017.11.014. Epub 2018 Jan 31.
Intensive care unit (ICU) enteral nutrition (EN) can involve frequent feeding interruption (FI). The prevalence, causes, and duration of such interruption were investigated.
Reasons for EN FI identified from extensive literature review were prospectively collected in adult mechanically ventilated critically ill patients. Results were reported by descriptive statistics. Baseline and nutritional characteristics between patients who died and those alive at day 60 were compared.
A total of 148 patients receiving ≥1 day of EN for the full 12-day observational period were included in the analysis. About 332 episodes of EN FI were recorded and contributed to 12.8% (4190 hours) of the total 1367 evaluable nutrition days. For each patient, FI occurred for a median of 3 days and the total duration of FI for the entire ICU stay was 24.5 hours. Median energy and protein deficits per patient due to FI for the entire ICU stay were -1780.23 kcal and -100.58 g, respectively. Duration of FI, days with FI, and the amount of energy and protein deficits due to FI were not different between patients who had died and those who were still alive at day 60 (all P > 0.05). About 72% of the total duration of EN FI was due to procedural-related and potentially avoidable causes (primarily human factors), while only about 20% was due to feeding intolerances.
EN FI occurred primarily due to human factors, which may be minimized by adherence to an evidence-based feeding protocol as determined by a nutrition support team.
重症加强护理病房（ICU）肠内营养（EN）可能会频繁中断喂养（FI）。本研究旨在调查这种中断的发生率、原因和持续时间。
从广泛的文献综述中确定了 EN FI 的原因，并前瞻性地收集了在接受机械通气的成年重症患者中的数据。结果以描述性统计数据报告。比较了在第 60 天死亡和存活的患者的基线和营养特征。
共纳入了 148 名接受至少 1 天 EN 治疗且整个 12 天观察期内接受评估的患者。记录了 332 次 EN FI 事件，占 1367 个可评估营养日的 12.8%（4190 小时）。对于每个患者，FI 持续时间中位数为 3 天，整个 ICU 住院期间 FI 的总持续时间为 24.5 小时。由于 FI 导致的每位患者整个 ICU 住院期间的平均能量和蛋白质缺乏量分别为-1780.23kcal 和-100.58g。FI 持续时间、FI 天数以及由于 FI 导致的能量和蛋白质缺乏量在第 60 天死亡和存活的患者之间没有差异（均 P＞0.05）。EN FI 总持续时间的 72%主要是由于程序相关和潜在可避免的原因（主要是人为因素），而只有约 20%是由于喂养不耐受。
EN FI 主要是由于人为因素导致的，通过营养支持小组确定的基于证据的喂养方案可以最大程度地减少这种情况。
