ObjectiveTo study the frequency of and risk factors for increased gastric aspirate volume (GAV) and upper digestive intolerance and their complications during enteral nutrition (EN) in critically ill patients.DesignProspective observational study.SettingIntensive care unit (ICU) in a general hospita

Upper digestive intolerance during enteral nutrition in critically ill patients: frequency, risk factors, and complications.

Purpose
To provide evidence-based guidelines for early enteral nutrition (EEN) during critical illness.

https://link.springer.com/content/pdf/10.1007%2Fs00134-016-4665-0.pdf

Early enteral nutrition in critically ill patients: ESICM clinical practice guidelines

ObjectiveTo evaluate those factors that impact on the delivery of enteral tube feeding.DesignProspective study.SettingMedical intensive care units (ICU) and coronary care units at two university-based hospitals.PatientsForty-four medical ICU/coronary care unit patients (mean age, 57.8 yrs; 70% male)

Enteral tube feeding in the intensive care unit: factors impeding adequate delivery.

ObjectiveTo evaluate the frequency of gastrointestinal complications (GICs) in a prospective cohort of critically ill patients receiving enteral nutrition and to assess its effect on nutrient administration and its relationship to the patient's outcome.DesignMulticenter, prospective cohort study.Set

Enteral nutrition-related gastrointestinal complications in critically ill patients: a multicenter study. The Nutritional and Metabolic Working Group of the Spanish Society of Intensive Care Medicine and Coronary Units.

Background: The provision of nutritional support for patients in intensive care units (ICUs) varies widely both within and between institutions. We tested the hypothesis that evidence-based algorithms to improve nutritional support in the ICU would improve patient outcomes. Methods: A cluster-randomized controlled trial was performed in the ICUs of 11 community and 3 teaching hospitals between October 1997 and September 1998. Hospital ICUs were stratified by hospital type and randomized to the intervention or control arm. Patients at least 16 years of age with an expected ICU stay of at least 48 hours were enrolled in the study ( n = 499). Evidence-based recommendations were introduced in the 7 intervention hospitals by means of in-service education sessions, reminders (local dietitian, posters) and academic detailing that stressed early institution of nutritional support, preferably enteral. Results: Two hospitals crossed over and were excluded from the primary analysis. Compared with the patients in the control hospitals ( n = 214), the patients in the intervention hospitals ( n = 248) received significantly more days of enteral nutrition (6.7 v. 5.4 per 10 patient-days; p = 0.042), had a significantly shorter mean stay in hospital (25 v. 35 days; p = 0.003) and showed a trend toward reduced mortality (27% v. 37%; p = 0.058). The mean stay in the ICU did not differ between the control and intervention groups (10.9 v. 11.8 days; p = 0.7). Interpretation: Implementation of evidence-based recommendations improved the provision of nutritional support and was associated with improved clinical outcomes.

/pdf/multicentre-cluster-randomized-clinical-trial-of-algorithms-hpe5uxu1xq.pdf

Multicentre, cluster-randomized clinical trial of algorithms for critical-care enteral and parenteral therapy (ACCEPT)

ObjectivesTo describe current enteral nutrition-prescribing practices for critically ill patients, and to identify factors associated with initiation of, and tolerance to, enteral nutrition.DesignA prospective, cohort study.SettingTwo tertiary care medical-surgical intensive care units (ICU) in Onta

Barb RPDt Winder

Papers

Enteral nutrition in the critically ill patient : a prospective survey