DOI QR코드

DOI QR Code

Nutritional Support, Gastric Residual Volume and Nutritional Status during Enteral Nutrition in Intensive Care Unit Patients

중환자실 경장영양 환자의 영양지원, 위 잔여량 및 영양상태

  • Lee, Minju (Kosin University Gaspel Hospital, SICU) ;
  • Kang, Jiyeon (Department of Nursing, Dong-A University)
  • 이민주 (고신대학교복음병원 외과계중환자실) ;
  • 강지연 (동아대학교 간호학과)
  • Received : 2014.07.01
  • Accepted : 2014.11.25
  • Published : 2014.12.31

Abstract

Purpose: The purpose of this study was to investigate the nutritional support, gastric residual volume, and nutritional status of the intensive care unit (ICU) patients on enteral feeding. Methods: A descriptive longitudinal design was used to collect 5 day data on enteral nutrition of 52 ICU patients in an university hospital. Nutritional support was calculated with actual caloric intake compared to individual caloric requirement. Residual volumes were measured prior to routine feedings, and the serum albumin levels and the total lymphocyte counts were checked to evaluate nutritional status. The data were analyzed using one group repeated measures ANOVA, paired t-test, and Spearman's bivariate correlation analysis. Results: The subjects received their first enteral feeding on the $5.75^{th}$ day of ICU admission. The mean nutritional support rate was 49.1% of the requirement, however prescription rate and support rate were increased as time goes by. Gastric residual volumes were less than 10 cc in 95% cases. A significant negative correlation was found between nutritional support and nutritional status. Conclusion: The nutritional support for ICU patient was low compared to the requirement, and their nutritional status was worse than at the time of ICU admission. Further studies are necessary to develop nursing interventions for improving nutritional support for ICU patients.

Keywords

References

  1. Elamin EM, Enrico C. Evidence-based nutritional support in the intensive care unit. International Anesthesiology Clinics. 2009;47(1):121-38. http://dx.doi.org/10.1097/AIA.0b013e3181950055
  2. Yun SH, Kim SJ, Oh EG. Healthcare professional's knowledge, perception and performance on early enteral nutrition for critically ill patients. Korean Journals Critical Care Medicine. 2012;27(1):36-44. http://dx.doi.org/10.4266/kjccm.2012.27.1.36
  3. McClave SA, Martindale RG, Vanek VW, McCarthy M, Roberts P, Taylor B. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). Journal of Parenteral and Enteral Nutrition. 2009;33(3):277-316. http://dx.doi.org/10.1177/0148607109335234
  4. Heyland DK, Dhaliwal R, Drover JW, Gramlich L, Dodek P. The canadian critical care clinical practice guidelines committee. Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult. Canadian clinical practice guidelines. Journal of Parenteral and Enteral Nutrition. 2009;27(5):355-73. http://dx.doi.org/10.1177/0148607103027005355
  5. Park YO, Kang EH, Park SJ, Park MA, Yoon SY, Kim SL, et al. A current survey of the gastric residual volume in critically ill patients who are receiving enteral nutrition. Journal of the Korean Society for Parental & Enteral Nutrition. 2009;2(1):24-9.
  6. Park EK. Degree of enteral tube feeding in the intensive care unit and change in nutritional status. [master's thesis]. Seoul: Yonsei University; 2000.
  7. De Jonghe B, Appere-De-Vechi C, Fournier M, Tran B, Merrer J, Melchior JC, et al. A prospective survey of nutritional support practices in intensive care unit patients: what is prescribed? What is delivered? Critical Care Medicine. 2001;29(1):8-12. https://doi.org/10.1097/00003246-200101000-00002
  8. Park EK, Lee JH, Lim HS. Degree of enteral tube in the intensive care unit and change in nutritional status. Journal of the Korean Dietetic Association. 2001;7(3):217-26.
  9. Barr J, Hecht M, Flavin KE, Khorana A, Gould MK. Outcomes in critically ill patients before and after the implementation of evidence-based nutritional management protocol. Chest. 2004;125(4):1446-57. https://doi.org/10.1378/chest.125.4.1446
  10. Dobson K, Scott A. Review of ICU nutrition support practice: implementing the nurse-led enteral feeding algorithm. Nursing in Critical Care. 2007;12(3):114-23. http://dx.doi.org/10.1111/j.1478-5153.2007.00222.x
  11. Appelboam R, Sair M. Nutrition in the critically ill patient. Anaesthesia and Intensive Care Medicine. 2006;7(2):121-3. https://doi.org/10.1383/anes.2006.7.4.121
  12. Bourgault AM, Ipe L, Weaver J, Swartz S, O'Dea PJ. Development of evidence-based guidelines and critical care nurses' knowledge of enteral feeding. Critical Care Nurse. 2007;27(4):17-29.
  13. Moon SS, Lim HS, Choi JW, Kim DK, Lee JW, Ko SH, et al. Analysis of nutritional support status in intensive care unit. The Korean Journal of Critical Care Medicine. 2009;24(3):129-33. http://dx.doi.org/10.4266/kjccm.2009.24.3.129
  14. Woien H, Bjork IT. Nutrition of the critically ill patient and effects of implementing a nutritional support algorithm in ICU. Journal of Clinical Nursing. 2006;15(2):168-77. http://dx.doi.org/10.1111/j.1365-2702.2006.01262.x
  15. NST Standardization Commission. Nutrition support guideline. Seoul: Korean Society for Parental & Enteral Nutrition; 2007.
  16. Kim ME. Development of performance measures based in nursing process for fluid intake/output and tube care. Seoul: Hospital Nurses Association; 2011. p. 49-57.
  17. Kim DS. Knowledge, perception and performance on nasogastric tube feeding in intensive care unit nurses. [master's thesis]. Wonju: Yonsei University; 2008.
  18. Moon SS. Analysis of nutritional supporting status in intensive care unit. [master's thesis]. Jeonju: Chonbuk National University; 2008.
  19. Heyland DK, Schroter-Noppe D, Drover JW, Jain M, Keefe L, Dhaliwal R, et al. Nutrition support in the critical care setting: current practice in Canadian ICUs-opportunities for improvement? Journal of Parenteral and Enteral Nutrition. 2003;27(1):74-83. https://doi.org/10.1177/014860710302700174
  20. Cahill NE, Dhaliwal R, Day AG, Jiang X, Heyland DK. Nutrition therapy in the critical care setting: what is "best achievable" practice? an international multicenter observational study. Critical Care Medicine. 2010;38(2):395-401. http://dx.doi.org/10.1097/CCM.0b013e3181c0263d
  21. Umezawa Makikado LD, Flordelis Lasierra JL, Perez-Vela JL, Colino Gomez L, Torres Sanchez E, Maroto Rodriguez B, et al. Early enteral nutrition in adults receiving venoarterial extracorporeal membrane oxygenation: an observational case series. Journal of Parenteral and Enteral Nutrition. 2013;37(2): 281-4. http://dx.doi.org/10.1177/0148607112451464
  22. Chi SN, Ko JY, Lee SH, Lim EH, Kown KH, Yoon MS, et al. Degree of Nutritional support and nutritional status in MICU patients. Journal of Nutrition and Health. 2011;44(5):384-93. http://dx.doi.org/10.4163/kjn2011.44.5.384
  23. Kirkland LL. Factors impeding enteral tube feedings. Critical Care Medicine. 1999;27(7):1383-84. https://doi.org/10.1097/00003246-199907000-00036
  24. Park JY. Evidence based guideline review for enteral nutrition. Paper presented at: the annual meeting of the Korean Society of Critical Care Nursing; 2012 September 21; Seoul, Korea.
  25. Kim H, Stotts NA, Froelicher ES, Engler MM, Porter C. Why patients in critical care do not receive adequate enteral nutrition? A review of the literature. Journal of Critical Care. 2012; 27(6):702-13. http://dx.doi.org/10.1016/j.jcrc.2012.07.019
  26. Higgins PA, Daly BJ, Lipson AR, Su-Er G. Assessing nutritional status in chronically critically ill adult patients. American Journal of Critical Care. 2006;15(2):166-76.
  27. Kim HS, Choi SH, Ham YJ. Nutritional status and indicators of intensive care unit patients on enteral feeding. Korean Journal of Fundamentals of Nursing. 2009;16(1):21-9.
  28. Choi HS. A study of aspiration, gastrointestinal intolerance and reaching of daily nutritional requirement calory in adult patients receiving enteral nutrition feeding. Paper presented at: The annual meeting of the Korean Society of Critical Care Nursing; 2012 September 21; Seoul, Korea.
  29. Sergi G, Coin A, Enze G, Valpate S, Inelmen EM, Buttarello M, et al. Role of visceral proteins in detecting malnutrition in the elderly. European Journal of Clinical Nutrition. 2006;60 (2):203-9. http://dx.doi.org/10.1038/sj.ejcn.1602289

Cited by

  1. 체외막산소화장치 (ECMO) 적용 중환자의 영양지표 비교 vol.54, pp.5, 2014, https://doi.org/10.4163/jnh.2021.54.5.489