Background: The intent of this study was to ascertain
the adequacy of delivery of enteral nutrition (EN) to critically ill adult multiple
trauma patients and to identify potential detrimental factors that affect EN
delivery. Methods: Retrospective observational study.
Trauma intensive care unit (TICU) in a university-affiliated hospital. Adult patients
(≥18 years of age) admitted to the TICU who received enteral feeding. Results: Fifty-six adult patients were enrolled for study.
Patients received, on average, 67% ± 19% of what was prescribed for 5.7 ± 2.0 days. A
total of 222 occurrences for temporary discontinuation of tube feeding were
identified. Gastrointestinal intolerance, as defined by a gastric residual volume of
>150 mL, abdominal pain, or >3 liquid stools per day, accounted for only 11% of
the occurrences for discontinuation of feeding. Surgery (27%) and diagnostic
procedures (15%) represented the majority of reasons for inadequate nutrient
delivery. Minor factors for EN interruptions were mechanical feeding tube problems
(8%), pharmacy delivery delay (4%), and miscellaneous factors (3%). Multiple and
unknown reasons contributed to 14% and 18% of the occurrences, respectively. Conclusions: Surgery and diagnostic procedures accounted for
the largest factor in enteral feeding discontinuations in our critically ill trauma
patients. Gastrointestinal intolerance contributed a minor role in the temporary
discontinuation of enteral feeding.
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