ICU Enteral Feeding Unsatisfactory

Researchers in The Netherlands have evaluated enteral nutrition in patients in the intensive care unit (ICU) and found the feeding process to be unsatisfactory.

The feeding practice of all ICU patients receiving enteral nutrition for at least 48 hours was recorded during a one-year period. The actual intake was expressed as a percentage of the prescribed volume of formula, with success defined as 90% or more. Prescribed volume was guided by protocol but adjusted to individual patient conditions by the intensivist physician.

In all, 403 patients were followed. The desired intake was successful in 52% of feeding days. The percentage of successful feeding days increased from 39% on day one to 51% on day five. Average ideal protein intake was 54%, energy intake was 66%, and volume intake was 75%. The factors found to impede successful nutrition were the use of the feeding tube to deliver contrast agents, the need for prokinetic drugs, a high level of therapeutic interventions, and elective admissions.

Dr. J.M. Binnekade and colleagues at the Academic Medical Center, University of Amsterdam (The Netherlands), concluded that a better use of relative successful volume intake, namely increasing the energy and protein density, could enhance the nutritional yield. Factors such as improper use of feeding tubes and feeding intolerance were related to failures. Meticulous recording of intake and interfering factors would help to uncover inadequacies in ICU feeding practices. The findings were reported in the March 21, 2005, issue of Critical Care, published online by BioMed Central (www.biomedcentral.com).




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