TITLE

NUTRITIONAL SUPPORT IN INTENSIVE CARE UNITS—NATIONAL SURVEY OF CURRENT PRACTICE IN THE UK

AUTHOR(S)
Kapoor, N.; Cooper, H.; O'Toole, P.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA98
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Aims: To establish attitudes and current practice regarding nutritional support in the ICU setting and to explore factors determining choice of feeding route. Methods: A questionnaire was sent to 324 ICUs in the UK. It comprised an attitudinal survey assessing unit policy and opinion in relation to nutritional support, and a "snap-shot" survey of current inpatients to determine how this policy was implemented in practice. Results: Completed questionnaires were returned by 112 units (35%), responsible for the care of 617 inpatients on the day of the survey. 416 patients (67%) were receiving artificial nutrition. 85% were on some form of enteral nutrition (EN) alone, 9% were receiving parenteral nutrition (PN) alone, and 6% were on a combination of EN and PN. Nasogastric (NG) feeding accounted for 90% of the EN group. In the attitudinal survey, most respondents (83%) agreed that NG feeding generally allowed patients to meet their nutritional requirements. However, frequent problems with NG feeding were reported in practice, with 30% needing tube replacement, 24% having absorption problems and 24% having unplanned interruptions to their feed. 51% of respondents agreed that those who fail NG will usually tolerate nasojejunal (NJ) feeding, yet only 15 patients had NJ tubes (2 with supplemental PN). Only 25% of units claimed to use NJ feeding regularly, while 18% units never use it. Of the 39 patients on PN, only 64% appeared to have an accepted contraindication to NJ feeding. NJ tubes were placed endoscopically in 6/13 patients with 3 placed blindly, 2 with fluoroscopy and 2 during surgery. 45 units reported difficulty in arranging endoscopic NJ tube placement. 62/109 units felt that a reliable NJ tube placement service would probably decrease their use of PN. Conclusions: EN is firmly established as the preferred choice for nutritional support in ICU patients. NG remains the main feeding route but is frequently associated with problems that may limit nutrient...
ACCESSION #
9747948

 

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