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Nutrition support in intensive care units in England: a snapshot of present practice

  • Mahtab N. Sharifi (a1), Anna Walton (a2), Gayatri Chakrabarty (a1), Tony Rahman (a3), Penny Neild (a1) and Andrew Poullis (a1)...
Abstract

Nutrition support is an important part of care management in critically ill patients, not only to prevent and treat malnutrition but also it has a significant impact on recovery from illness and overall outcome. There is little information available about present nutritional support practice for patients in intensive care units (ICU) in the UK. This survey was designed to evaluate the present nutrition support practice in ICU and high dependency units (HDU) in England. Data were gathered by a 72 h phone survey from 245 ICU and HDU in 196 hospitals in England. A questionnaire was completed over the telephone, including general information, nutrition support and teams involved in the nutrition management in the ICU. Of 1286 total patients in the ICU, 703 (54·6 %) were receiving nasogastric feeding, two (1·5 %) were receiving feeding via a percutaneous endoscopically placed gastrostomy tube and two (1·5 %) were receiving nasojejunal feeding. One hundred and forty-seven (11·4 %) patients were on parenteral feeding during the study period. A nutrition support team was not available in 158 (83·1 %) ICU and there was no dietitian or specialist nutrition nurse to cover ICU in nine (4·7 %) hospitals. In conclusion, the present survey reported an increased trend in usage of enteral feeding in ICU in England, and a reduction in the use of parenteral nutrition compared with previous surveys. However, we are still far from integrating nutrition into care management in the ICU.

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Corresponding author
*Corresponding author: Dr A. Poullis, fax +44 20 8725 3520, email andrew.poullis@stgeorges.nhs.uk
References
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1 Elia, M & Stroud, M (2004) Nutrition in acute care. Clin Med 4, 405407.
2 Correia, MI & Waitzberg, DL (2003) The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr 22, 235239.
3 O'Daly, BJ, Walsh, JC, Quinlan, JF, et al. (2010) Serum albumin and total lymphocyte count as predictors of outcome in hip fractures. Clin Nutr. 29, 8993.
4 Elia, M & Stratton, RJ (2000) How much under-nutrition is there in British hospitals? Br J Nutr 84, 257259.
5 Giner, M, Laviano, A, Meguid, MM, et al. (1996) In 1995 a correlation between malnutrition and poor outcome in critically ill patients still exists. Nutrition 12, 2329.
6 Malnutrition Advisory Group, a standing committee of British Association for Parenteral and Enteral Nutrition (2003) Nutritional screening for adults – a multidisciplinary responsibility. Press release, MUST Launch London, Nov 11. http://bapen.org.uk/res_press_rel12.html.
7 Garth, AK, Newsome, CM, Simmance, N, et al. (2010) Nutritional status, nutrition practices and post-operative complications in patients with gastrointestinal cancer. J Hum Nutr Diet 23, 393401.
8 Teitelbaum, D, Guenter, P, Howell, WH, et al. (2005) American Society for Parenteral and Enteral Nutrition Board of Directors and Standards Committee: Definition of terms, style, and conventions used in A.S.P.E.N. guidelines and standards. Nutr Clin Pract 20, 281285.
9 Hill, SA, Nielsen, MS & Lennard-Jones, JE (1995) Nutritional support in intensive care units in England and Wales: a survey. Eur J Clin Nutr 49, 371378.
10 Braunschweig, CL, Levy, P, Sheean, PM, et al. (2001) Enteral compared with parenteral nutrition: a meta-analysis. Am J Clin Nutr 74, 534542.
11 Heyland, DK, Dhaliwal, R, Drover, JW, et al. (2003) Canadian Critical Care Clinical Practice Guidelines Committee. Canadian clinical practice guidelines for nutrition support in mechanically ventilated,critically ill adult patients. JPEN J Parenter Enteral Nutr 27, 355373.
12 Gramlich, L, Kichian, K, Pinilla, J, et al. (2004) Does enteral nutrition compared to parentral nutrition result in better outcome in critically ill adult patients? A systemic review of literature. Nutrition 20, 843848.
13 Heyland, DK, Drover, JW, Dhaliwal, R, et al. (2004) Optimizing the benefits and minimizing the risks of enteral nutrition in the critically ill: role of small bowel feeding. JPEN Parenter Enteral Nutr 26, Suppl. 6, S51S57.
14 Melis, M, Fichera, A & Ferguson, MK (2006) Bowel necrosis associated with early jejunal tube feeding: a complication of postoperative enteral nutrition. Arch Surg 141, 701704.
15 Zaloga, GP, Roberts, PR & Marik, P (2003) Feeding the hemodynamically unstable patient: a critical evaluation of the evidence. Nutr Clin Pract 18, 285293.
16 Khalid, I, Doshi, P & DiGiovine, B (2010) Early enteral nutrition and outcomes of critically ill patients treated with vasopressors and mechanical ventilation. Am J Crit Care 19, 261268.
17 Woien, H & Bjork, IT (2006) Nutrition of critically ill patient and effect of implementing a nutritional support algorithm in ICU. J Clin Nurs 15, 168177.
18 National Institute for Clinical Excellence (NICE) (2006) CG32 Nutrition Support in Adult: Full Guidance, pp. 5661. London: NICE.
19 Cano, NJM, Aparicio, M, Brunori, G, et al. (2009) ESPN guidelines for adult parenteral nutrition. Clin Nutr 28, 359479.
20 Rubinson, L, Diette, GB, Song, XS, et al. (2004) Low calorie intake is associated with noscomial bloodstream infections in patients in the medical intensive care unit. Crit Care Med 32, 350357.
21 Dvir, D, Cohen, J & Singer, P (2006) Computerized energy balance and complication in critically ill patients: an observational study. Clin Nutr 25, 3744.
22 Kirshman, JA, Parce, PB, Martinez, A, et al. (2003) Caloric intake in medical ICU patients. Consistency of care with guidelines and relationship to clinical outcomes. Chest 124, 297305.
23 National Confidential Enquiry into Patients Outcome and Death (NCEPOD) report (2010) Parenteral nutrition: a mixed bag 2010, Parenteral Nutrition toolkit. http://ncepod.org.uk/2010pn.htm.
24 McClave, SA, Martindale, RG, Vanek, VW, et al. (2009) 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 (ASPEN). JPEN J Parenter Enteral Nutr 33, 277316.
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British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
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