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Nutrición Hospitalaria
On-line version ISSN 1699-5198Print version ISSN 0212-1611
Abstract
BATASSINI, Éica; ASSIS, Michelli Cristina Silva de; SOUSA, Gabriele Peres de and BEGHETTO, Mariur Gomes. Factors associated with enteral nutrition and the incidence of gastrointestinal disorders in a cohort of critically ill adults. Nutr. Hosp. [online]. 2021, vol.38, n.3, pp.429-435. Epub July 12, 2021. ISSN 1699-5198. https://dx.doi.org/10.20960/nh.03245.
Introduction:
adults in intensive care commonly receive enteral nutrition (EN). Data describing the conditions associated with EN in critically ill patients are limited.
Objective:
to describe the incidence of gastrointestinal disorders and to identify conditions associated with the use of EN.
Methods:
a prospective cohort, single-center study of critically ill adults. The patients were followed daily for the first 10 days of hospitalization in the intensive care unit (ICU) or until ICU discharge or death. Clinical, nutritional variables and gastrointestinal disorders were compared between patients who did and did not receive EN. Univariate and multivariate regression identified the conditions associated with EN with the proposed variables.
Results:
of the 157 included adults, 62 % received EN. The EN group had higher APACHE II (23.6 ± 7.6 vs. 15 ± 7.2, p < 0.001) and SOFA scores on the day of ICU admission [7 (-.) vs. 4 (-); p < 0.001], and higher ICU mortality (32 % vs. 10 %, p = 0.002). Diarrhea and need for gastric decompression were more frequent in the EN group (39.7 % vs. 11.7 %, p < 0.001 and 34 % vs. 13.3 %, p = 0.004, respectively). The multivariate analysis showed that neurological deficit (OR: 16.7 [95 % CI: 5.9-46.9]; p < 0.001), previous enteral tube feeding (OR: 45.1 [95 % CI: 5.3-380]; p < 0.001), and SOFA score on the day of ICU admission (OR: 1.2 [95 % CI: 1.01-1.3]; p = 0.03) were associated with EN.
Conclusions:
conditions related to the severity of critically ill patients, such as higher SOFA scores, greater neurological deficit, and prior enteral tube feeding, were more commonly associated with EN. Diarrhea and need for gastric decompression were more frequent in patients who received EN.
Keywords : Critical care; Enteral nutrition; Gastrointestinal motility; Gastrointestinal intubation; Risk factors; Complications.