Nutritional Adequacy in Patients of the Intensive Care Unit in Suez Canal University Hospital Who are Tube Fed Enterally
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- Category: Vol. 77, March 2009
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Nutritional Adequacy in Patients of the Intensive Care Unit in Suez Canal University Hospital Who are Tube Fed Enterally,GHADA S. FOUDA, ALAA EL-DIN EL-KASSABY, ALAA EL-DIN SAAD ABDELHAMID and AMR HELMY
Abstract
Objectives: To assess the actual energy received by the patients of the intensive care unit in Suez Canal University hospital who are enterally fed compared to their estimated daily caloric requirement and to find out the causes of inter-ruption of tube feeding.
Subjects and Methods: A descriptive study, to assess the adequacy of enteral tube nutrition intake and the factors that affect its delivery in the critically ill patients in Suez Canal university hospital, by monitoring the patients nutrition by Harris benedict equation (HBE) and laboratory investigations. The study was carried out in the general intensive care unit. All the patients receiving enteral nutrition were included with a target sample size of 92 patients. A date sheet was used to collect informations about the daily nutritional intake along with daily laboratory investigations including baseline values of blood glucose, potassium, phosphorus and blood gases, Urine analysis, CBC, triglycerides, creatinine, BUN, sodium, chloride, calcium, magnesium, coagulation, liver enzymes, billirubin, amylase, total protein, transferrin and transthyretin, twice weekly measurement of blood glucose, potassium, phosphorus and blood gases and once weekly measurement of CBC, triglycerides, creatinine, BUN, sodium, calcium, magnesium, coagulation, liver enzymes, billirubin, amylase, total protein, transferrin, transthyretin and urine analysis. Patients were followed up until enteral feeding withheld or death.
Results: Through following up the patients by measuring the daily caloric intake and laboratory investigations, the study showed that 67.4% of the patients were underfed and only 29.3% were adequately fed. The mean cause of feeding interruption was gastrointestinal factors (65.2%), such as vomiting and diarrhea, followed by intensive care unit factors (10.9%), such as surgical procedures and diagnostic procedures. Significant decrease in the values of BUN, total billirubin, total protein (T.protein), magnesium, PH and bicarbonate was found one week after starting enteral feeding.
Conclusion: The majority of the included patients were found to be underfed. Gastrointestinal problems as diarrhea and vomiting played a major rule in unsuccessful delivery of adequate energy requirements to the patients.