Optimal Energy Delivery, Rather than the Implementation of a Feeding Protocol, May Benefit Clinical Outcomes in Critically Ill Patients
| Autor: | Chao-Hsiu Chen, Chen-Yu Wang, Mei-Fen Chen, Shiu-Lan Ching, Chun-Te Huang, Yi-Chia Huang |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
energy delivery
feeding protocol clinical outcomes critically ill patients 0301 basic medicine Male Pediatrics medicine.medical_specialty Critical Illness lcsh:TX341-641 Enteral administration Article 03 medical and health sciences Enteral Nutrition Intensive care Medicine Humans Aged Retrospective Studies Protocol (science) Aged 80 and over 030109 nutrition & dietetics Nutrition and Dietetics business.industry Nutritional Support Mortality rate Confounding Health Plan Implementation Nutritional Requirements Odds ratio Middle Aged medicine.disease Confidence interval Malnutrition Intensive Care Units Treatment Outcome Female business Energy Intake lcsh:Nutrition. Foods and food supply Food Science |
| Zdroj: | Nutrients Nutrients; Volume 9; Issue 5; Pages: 527 Nutrients, Vol 9, Iss 5, p 527 (2017) |
| ISSN: | 2072-6643 |
| Popis: | Malnutrition is common in intensive care units (ICU), and volume based feeding protocols have been proposed to increase nutrient delivery. However, the volume based approach compared to trophic feeding has not been proven entirely successful in critically ill patients. Our study aimed to compare the clinical outcomes both before and after the implementation of the feeding protocol, and to also evaluate the effects of total energy delivery on outcomes in these patients. We retrospectively collected all patient data, one year before and after the implementation of the volume-based feeding protocol, in the ICU at Taichung Veterans General Hospital. Daily actual energy intake from enteral nutritional support was recorded from the day of ICU admission until either the 7th day of ICU stay, or the day of discharge from the ICU. The energy achievement rate (%) was calculated as: (actual energy intake/estimated energy requirement) × 100%. Two-hundred fourteen patients were enrolled before the implementation of the volume-based feeding protocol (pre-FP group), while 198 patients were enrolled after the implementation of the volume-based feeding protocol (FP group). Although patients in the FP group had significantly higher actual energy intakes and achievement rates when compared with the patients in the pre-FP group, there was no significant difference in mortality rate between the two groups. Comparing survivors and non-survivors from both groups, an energy achievement rate of less than 65% was associated with an increased mortality rate after adjusting for potential confounders (odds ratio, 1.6, 95% confidence interval, 1.01–2.47). The implementation of the feeding protocol could improve energy intake for critically ill patients, however it had no beneficial effects on reducing the ICU mortality rate. Receiving at least 65% of their energy requirements is the main key point for improving clinical outcomes in patients. |
| Databáze: | OpenAIRE |
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