Adequacy of nutritional support provided by enteral feeding: a comparison of two hospitals
Keywords:
Nutritional status, Enteral nutrition, Nutrition therapyAbstract
Objective
The objective of this study was to assess the nutritional status of inpatients and compare the enteral feeding practices of two general hospitals in the metropolitan region of Maringá (PR), Brazil.
Methods
The study included 62 patients of both sexes on exclusive enteral feeding. The data were collected in two general hospitals. The energy requirements of the patients were estimated using the equations proposed by Harris & Benedict and the European Society for Clinical Nutrition and Metabolism recommendation. The nutritional status of the patients was determined by anthropometric assessment.
Results
High rates of malnutrition were found in both hospitals, especially when the mid-arm muscle area was used as the indicator of nutritional status. The energy prescription was adequate for 45.71% and 40.74% of the patients of hospitals 1 and 2, respectively.
Conclusion
Inadequate enteral feeding associated with high rates of malnutrition was found in both hospitals. The data obtained in this study show that both enteral feeding services need improvements. Standardization of enteral feeding practices and regular patient assessment are also needed.
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References
Genton L, Hans D, Kyle UG, Pichard C. Dual-energy X-ray absorptiometry and body composition: differences between devices and comparison with reference methods. Nutrition. 2002; 18(1):66-70.
Engel JM, Muhling J, Junger A, Menges T, Karcher B, Hempelmann G. Enteral nutrition practice in a surgical intensive care unit: what proportion of energy expenditure is delivered enterally? Clin Nutr. 2003; 22(2):187-92.
Waitzberg DL, Caiafa WT, Correia MITD. Hospital malnutrition: the Brazil National Survey (IBRANUTRI): a study of 4000 patients. Nutrition. 2001; 17(7): 573-80.
Watanabe S, Cukier C, Magnoni D, Guimarães RN, Urenhiuki KL, Rauba A. Nutrição enteral precoce reduz tempo de internação hospitalar e melhora reembolso diário do Sistema Único de Saúde (SUS) ao hospital. Rev Bras Nutr Clin. 2002; 17(2):47-50.
McClave AS, McClain CJ, Snider HL. Should indirect calorimetry be used as part of nutritional assessment? J Clin Gastroenterol. 2001; 33(1):14-9.
Krishnan JA, Parce PB, Matinez A, Diette GB, Brower RG. Caloric intake in medical ICU patients. Chest. 2003; 124(1):297-305.
Reid C. Frequency of under- and over feeding in mechanically ventilated ICU patients: causes and possible consequences. J Hum Nutr Diet. 2006; 19(1):13-22.
Ravasco P, Camilo ME. The impact of fluid therapy on nutrient delivery: a prospective evaluation of practice in respiratory intensive care. Clin Nutr. 2003; 22(1):87-92.
Woien H, Bjork IT. Nutrition of the critically ill patient and effects of implementing a nutritional support algorithm in ICU. J Clin Nurs. 2006; 15(2):168-77.
Klein CJ, Stanek GS, Wiles CE. Over feeding macronutrients to critically ill adults: metabolic complications. J Am Diet Assoc. 1998; 98(7):795-806.
Ireton-Jones C, Jones J. Should predictive equations or indirect calorimetry be used to design nutrition support regimens? NCP. 1998; 13(3):141-3.
MacDonald A, Hildebrandt L. Comparison of formulaic equations to determine energy expenditure in the critically Ill patient. Nutrition. 2003; 19(3):233-9.
Genton L, Dupertuis YM, J Romand, Simonet ML, Jolliet P, Huber O, et al. Higher calorie prescription improves nutrient delivery during the first 5 days of enteral nutrition. Clin Nutr. 2004; 23 (3): 307-15.
Harris JA, Benedict FG. A biometric study of basal metabolism in man. Washington (DC): Carnegie Institute of Washington; 1919. Publication n.279.
Sociedad Española de Nutrición Parenteral y Enteral: protocolos para la prescripción de nutrición parenteral y enteral. Documento 2-C-EP, 1998. Zaragoza: SENPE; 1998.
Kreymann KG, Berger MM, Deutz NEP, Hiesmayr M, Jolliete P, Kazandjiev G, et al. ESPEN Guidelines on Enteral Nutrition: intensive care. Clin Nutr. 2006; 25(2):210-23.
Long CL, Schaffel N, Geiger JW, Schiller WR, Blackmore WS. Metabolic response to injury and illness. Estimation of energy and protein needs from indirect calorimetry and nitrogen balance. J Pen. 1979; 3(6):452-6.
Frisancho AR. Anthropometric standards for assessment of growth and nutrition status. Michigan: The University of Michigan Press; 1990.
World Health Organization. Obesity: preventing and managing the global epidemic. Geneva: WHO; 1997. Report of WHO Consulation on Obesity.
Chumlea WC, Roche AF, Mukherjee D. Ross Laboratories. Nutritional assessment of the elderly through anthropometry. Ohio: Ross Laboratories; 1987.
Tritschler KA. Medida e avaliação em educação física e esportes. 5a. ed. São Paulo: Manole; 2003.
Waitzberg DL, Gama-Rodrigues J, Correia MITD. Desnutrição hospitalar no Brasil. In: Waitzberg DL, editor. Nutrição oral, enteral e parenteral na prática clínica. São Paulo: Atheneu; 2001. p.385-97.
Silva AFF, Campos DJ, Souza MH, Shieferdecker ME. Capacidade da terapia nutricional enteral em fornecer as necessidades calórico-protéicas de pacientes hospitalizados. Rev Bras Nutr Clin. 2003; 18(3):113-8.
Correia MITD, Campos ACL. Prevalence of Hospital malnutrition in Latin America: the Multicenter ELAN Study. Nutrition. 2003; 19(10):823-5.
De Jonghe B, Appere-De-Vechi C, Fournier M, Tran B, Merrer J, Melchior JC, et al. A prospective survey of nutritional support practices in intensive care unit patients: what is prescribed? What is delivered? Crit Care Med. 2001; 29(1): 8-12.
O’Leary-Kelley CM, Puntillo KA, Barr J, Sttots N, Douglas MK. Nutritional adequacy in patients receiving mechanical ventilation who are fed enterally. Am J Crit Care. 2005; 14(3):222-31.
Roberts SR, Kennerly DA, Keane D, George C. Nutrition support in the intensive care unit: adequacy, timeliness and outcomes. Crit Care Nurse. 2003; 23(6):49-57.
Kyle UG, Genton L, Heidegger CP, Maisonneuve N, Karsegard VL, Huber O, et al. Hospitalized mechanically ventilated patients are at higher risk of enteral underfeeding than non-ventilated patients. Clin Nutr. 2006; 25(5):727-35.
Petros S, Engelmann L. Enteral nutrition delivery and energy expenditure in medical intensive care patients. Clin Nutr. 2006; 25(1):51-9.
Couto JCF, Bento A, Couto CMF, Silva BCO, Oliveira IAG. Nutrição enteral em Terapia Intensiva: o paciente recebe o que prescrevemos? Rev Bras Nutr Clin. 2002; 17(2):43-6.
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