Use of enteral nutrition and factors influencing feeding intolerance in severely ill patients in the intensive care unit

Abstract

Purpose: To investigate the use of enteral nutrition (EN) and factors influencing feeding intolerance (FI) in severely ill patients in intensive care unit (ICU).Methods: Retrospective data collection was performed on records of 247 severely ill patients admitted to ICU of the West China Hospital, Chengdu, China between January 2020 and December 2022. Data were divided into two groups: FI group (n = 107) and non-FI group (n = 140). Influencing factors of FI were analyzed by univariate and multivariate analysis, and the use of EN was analyzed.Results: Defined daily doses (DDDs) of enteral nutrition emulsion TPF-T (Ruineng), enteral nutrition suspension (Baipuli) and enteral nutrition emulsion TPF (Ruixian) were most prevalent. The DDDs of enteral nutrition suspension (Nengquanli 1.5) increased, while that of Nengquanli 1.0 decreased. Univariate analysis showed significant differences between FI and non-FI groups in start time of EN, addition of dietary fiber, Acute Physiology and Chronic Health Evaluation (APACHE) II score, use of sedatives, types of antibiotics used, use of vasoactive drugs and oral potassium preparation, mechanical ventilation and hypoalbuminemia (p < 0.05). Multivariate analysis showed that addition of dietary fiber, APACHE II score ≥ 20 points, sedatives use, types of antibiotics used ≥ 2, oral potassium preparation and hypoalbuminemia were independent risk factors of FI.Conclusion: Use of EN in ICU is consistent. Factors that influence FI in critically ill patients include dietary fiber, APACHE II score, use of sedatives, use of antibiotics, use oral potassium preparations and hypoalbuminemia. Knowledge of these risk factors and timely measures are of great significance in avoiding FI in ICU.