Newsletter

[ Vol. 11 No. 2 ] (May - August 2010 )
Change of nutrtional status in critically ill patients initiated on early enteral nutrition

M Bamini, N Pavithra, Poora Anand, Virinda Rajkumar
Department of Nutrition Support Service, Sundaram Medical Foundation, Dr Rangarajan Memorial Hospital, Chennai, India.

BACKGROUND
Critically ill patients develop malnutrition rapidly due to stress starvation. Maintaining nutritional status of patients is essential for recovery and is considered a quality indicator of patient care.

AIM
To assess change of nutritional status in critically ill patients initiated on early enteral nutrition.

METHODS
Retrospective Cohort study conducted in the critical care unit between 1/1/08 to 20/1/09. All patients initiated on enteral nutrition within 24hrs of admission were included. A structured audit form was used. Nutritional status was assessed using Subjective Global Assessment [SGA] on admission and discharge.

RESULTS
Total number of patients was 242. Total enteral nutritional days were 2916 days. The age range was 15-90yrs [mean-52yrs] with 156 males and 86 females. The route of the feeding tube was nasogastric in 199; orogastric 37 and jejunostomy 6. Calorie requirement [100%] was achieved within 1-3 days in 96.7%. The nutritional status on admission was well nourished in 48% at risk in 41% and malnourished in 11%. Of the well-nourished 79.3% maintained nutritional status, 2.6% deteriorated, 16.4% expired and 1.7% were transferred to another hospital. Of the at risk patients, 58.6% were unchanged, 6% improved, 1% deteriorated and 34% expired. Of the malnourished 33.3% improved, 18.5% remain unchanged, 7.4% were transferred and 40.7% expired.

CONCLUSION
Early enteral nutrition facilitates maintenance and may improve the nutritional status of critically ill patients. SGA is useful to assess and monitor the nutritional status.

From  
PENSA 2009
“Energizing Nutrition Support Practice for Life”
June 5-7 2009, Shangri-La Hotel, Kuala Lumpur, Malaysia 
Page: 68