• Journal of critical care · Apr 2020

    Multicenter Study

    The effects of an enteral nutrition feeding protocol on critically ill patients: A prospective multi-center, before-after study.

    • Libing Jiang, Xiaoxia Huang, Chunshuang Wu, Jiaying Tang, Qiang Li, Xiuqin Feng, Tao He, Zhengquan Wang, Jindan Gao, Zhanwei Ruan, Weili Hong, Dengpan Lai, Fei Zhao, Zhiping Huang, Zhifeng Lu, Weidong Tang, Lijun Zhu, Bingwen Zhang, Zhi Wang, Xiaoyuan Shen, Jiawei Lai, Zhaohui Ji, Kai Fu, Yucai Hong, Junru Dai, Guangliang Hong, Wenqing Xu, Yi Wang, Yun Xie, Yuxi Chen, Xiuhua Zhu, Guojuan Ding, Lanru Gu, and Mao Zhang.
    • Department of Emergency Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88, Jiefang Rd, Hangzhou, China.
    • J Crit Care. 2020 Apr 1; 56: 249-256.

    PurposeThe aim of this study was to explore the effects of an enteral nutrition (EN) feeding protocol in critically ill patients.MethodsThis was a prospective multi-center before-after study. We compared energy related and prognostic indicators between the control group (pre-implementation stage) and intervention group (post-implementation stage). The primary endpoint was the percentage of patients receiving EN within 7 days after ICU admission.Results209 patients in the control group and 230 patients in the intervention group were enrolled. The implementation of the EN protocol increased the percentage of target energy reached from day 3 to day 7, and the difference between two groups reached statistical significance in day 6 (P = .01) and day 7 (P = .002). But it had no effects on proportion of patient receiving EN (P = .65) and start time of EN (P = .90). The protocol application might be associated with better hospital survival (89.1% vs 82.8%, P = .055) and reduce the incidence of EN related adverse (P = .004). There was no difference in ICU length of stay, duration of mechanical ventilation and ICU cost.ConclusionThe implementation of the enteral feeding protocol is associated with improved energy intake and a decreased incidence of enteral nutrition related adverse events for critically ill patients, but it had no statistically beneficial effects on reducing the hospital mortality rate. Trial registration ClinicalTrials.gov, NCT02976155. Registered November 29, 2016- Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02976155.Copyright © 2019 Elsevier Inc. All rights reserved.

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