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Clinical nutrition

Factors associated with discrepancy between prescribed and administered enteral nutrition in general ICU

European Journal of Clinical Nutrition volume 74, pages 248–254 (2020)Cite this article

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Abstract

Background

Discrepancy between prescribed and administered enteral nutrition (EN) is a common problem during intensive care. The aim of this study was to find out the success rate and factors associated with inadequacy of enteral nutrition in a mixed general intensive care unit (ICU).

Methods

This was a retrospective single-center study of 892 patients with ICU length of stay (LOS) ≥4 days. The factors associated with adequacy of enteral nutrition on day 4 were analyzed. These included disease-specific factors, patient-related factors, severity of illness, and procedural factors.

Results

Of the 892 patients, 349 (39.1%) had an EN success rate of ≥70%, which was associated with a lower amount of prescribed enteral energy (500 kcal [500–800] vs. 800 kcal [500–1200], p < 0.001) and bolus administration of enteral nutrition (41 of 349 vs. 27 of 543, p < 0.001). Other factors impairing successful EN were severe inflammation, surgery, and GI-related admission diagnosis.

Conclusions

On the fourth day during ICU stay discrepancy between prescribed and administered enteral nutrition was associated to severe inflammation, GI-related diagnosis, and prescribing policy.

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Author contributions

JN was responsible for designing the review protocol, writing the protocol and report, conducting the search, screening potentially eligible studies, extracting and analyzing the data, interpreting the results and updating the reference lists. TK was responsible for analyzing the data and contributed to writing the report. MV and TA provided feedback on the report. JHL was responsible for designing the review protocol and screening potentially eligible studies. He contributed to writing the report, extracting and analyzing the data, and interpreting the results.

Funding

The study was funded by grants from Oulu University Hospital.

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Authors and Affiliations

  1. University of Oulu, Medical Research Center, Research Group of Surgery, Anaesthesia and Intensive Care and Department of Anaesthesiology, Oulu University Hospital, Oulu, Finland

    Juho Nurkkala, T. Kaakinen, M. Vakkala, T. Ala-Kokko & Janne H. Liisanantti

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  1. Juho Nurkkala
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  2. T. Kaakinen
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  3. M. Vakkala
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  4. T. Ala-Kokko
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  5. Janne H. Liisanantti
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Correspondence to Juho Nurkkala.

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Nurkkala, J., Kaakinen, T., Vakkala, M. et al. Factors associated with discrepancy between prescribed and administered enteral nutrition in general ICU. Eur J Clin Nutr 74, 248–254 (2020). https://doi.org/10.1038/s41430-019-0451-8

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