Impact of a natural versus commercial enteral-feeding on the occurrence of diarrhea in critically ill cardiac surgery patients. A retrospective cohort study
| Autor: | Gianfranco Sanson, Aniello Pappalardo, Marisa Sacilotto, Michela Zanetti, Daniele Bottigliengo, Adam Fabiani, Giuseppe Gatti, Dario Gregori, Lorella Dreas, Giulia Lorenzoni |
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| Přispěvatelé: | Fabiani, Adam, Sanson, Gianfranco, Bottigliengo, Daniele, Dreas, Lorella, Zanetti, Michela, Lorenzoni, Giulia, Gatti, Giuseppe, Sacilotto, Marisa, Pappalardo, Aniello, Gregori, Dario |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Blenderized diet
Cardiac surgery Critical care Diarrhea Enteral nutrition Male medicine.medical_specialty Critical Illness Enteral administration law.invention Cohort Studies Hospitals University 03 medical and health sciences Enteral Nutrition 0302 clinical medicine law Internal medicine medicine Humans 030212 general & internal medicine Cardiac Surgical Procedures Correlation of Data General Nursing Aged Proportional Hazards Models Retrospective Studies Biological Products 030504 nursing business.industry Incidence Hazard ratio Retrospective cohort study medicine.disease Intensive care unit Intensive Care Units Malnutrition Parenteral nutrition Italy Cohort Female medicine.symptom 0305 other medical science business |
| Popis: | Background Diarrhea is an important complication in critically ill patients undergoing enteral feeding. The occurrence of diarrhea may lead to systemic and local complications and negatively impacts on nursing workload and patient's wellbeing. An enteral feeding based on blenderized natural food could be beneficial in reducing the risk of diarrhea. No study has compared natural and commercial enteral feedings in critically ill cardiac surgery patients. Objective The aim of this study was to compare the risk of diarrhea occurrence in two cohorts of patients fed a blenderized natural food diet or commercial enteral feeding preparations, respectively. Design Retrospective cohort study. Setting Cardiac-Surgery Intensive Care Unit of a University Hospital. Participants Two-hundred and fifteen patients admitted to the postoperative cardiac surgery intensive care unit were included, 103 fed blenderized natural enteral feeding and 112 fed commercial formulas. Methods Commercial enteral formulas were delivered by continuous pump administration, while natural enteral feeding by bolus 3 times per day. Diarrhea was documented in the presence of three or more evacuations of loose or watery stool (or an amount above 250 ml) per day. The presence of diarrhea was recorded daily from the beginning to the end of the enteral feeding, up to a maximum of 8 days. The unadjusted time to the first event of diarrhea between the two enteral feeding groups was compared. Adjusted comparison was then performed by fitting a multivariable Cox Proportional-Hazards model, adjusted for potential confounders for diarrhea occurrence (i.e. administration of inotropes, vasopressors, prokinetics, antibiotics, oral nutritional supplements, antifungal agents, sedatives, opioids, probiotics, laxatives). Results In unadjusted survival analysis the probability of diarrhea was significantly lower in the natural enteral feeding group (log rank test: p = 0.023). In the multivariable model patients in natural enteral feeding cohort showed a non-significant trend towards an almost halved risk of experiencing diarrhea (hazard ratio: 0.584; 95% confidence interval: 0.335–1.018; p = 0.058) compared to those fed commercial enteral feeding. Conclusions Administration of a blenderized diet based on natural food for enteral feeding can reduce the incidence of diarrhea in cardiac surgery critically ill patients. This strategy may reduce the risk of diarrhea-associated malnutrition and systemic and local complications, also having a positive impact on nursing workload and patient wellbeing. |
| Databáze: | OpenAIRE |
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