Assessment of enteral nutrition adequacy in patients hospitalized in adult intensive care units: a cross-sectional study.

Abstract

Introduction: In the principles of intensive care, nutritional support is an important part of critical care. This study was conducted to evaluate the adequacy of enteral nutrition in patients hospitalised in adult intensive care units.

Methods: The present study was designed as a cross-sectional study and it was carried out on 124 patients who received enteral nutrition in the adult intensive care unit of a training and research hospital between 01.03.2022 and 01.04.2022. Patients who received parenteral nutrition during the one-month follow-up were excluded from the study. The study used the Enteral Nutrition Information Form and the baseline NRS-2002 score. Energy needs of patients were calculated by Schofield method and addition of stress factors. Daily energy intake was recorded for each patient every day during hospitalization. Backward stepwise logistic regression analysis, Shapiro-Wilk, Student-t, Mann-Whitney U, Kruskal-Wallis, Dunn-Bonferroni, Pearson chi-squared, and Fisher's exact tests were used to evaluate the data.

Results: Mean age of the patients was 70.9±16.7 years (21-98) and 58.9% were male. The mean baseline NRS-2002 score was 5.88±1.23. Enteral nutrition started an average of 2.4±2.2 days (range 0-18) after ICU hospitalization. The mean target energy intake according to Schofield method was 1772.9±284.3 kcal, while the actual intake was 1463.5±386.2 kcal. Only 37.1% of patients achieved the target dose, taking an average of 4.5±4.2 days (1-20) to reach it In 25% of patients, feeding was interrupted due to residual volumes exceeding 500 ml, with 54.8% of these receiving hypercaloric products. Patients with neurological and cardiac diagnoses had significantly higher rates of reaching the target dose (p=0.001), while those with interruptions due to high residual volumes had lower rates (p=0.003). Finally, the overall mortality rate was 59.7%.

Conclusion: More than half of the patients did not meet the goals set for enteral nutrition therapy. A lower baseline NRS-2002 score and low energy requirements facilitated goal attainment. Patients with cardiac or neurological conditions were more likely to reach the target nutritional dose. However, those fed with hypercaloric products experienced more interruptions due to excess residue and achieved the nutritional target less frequently.