Changing to a volume-based system of tube feeding can improve nutrition and reduce the risk of underfeeding for ICU patients, according to a new study. While enteral nutrition, or feeding patients through a tube, is common among ICU units, underfeeding still can be a problem.
Common practice is for patients to receive a certain amount of feeding per hour, but feeding often can be interrupted by tests, procedures or emergencies. Researchers from Barnes-Jewish Hospital in St. Louis, Rutgers University in Newark, N.J., and Washington University School of Medicine in St. Louis studied whether a system of volume-based feeding, which calls for patients to receive a certain nutritional volume per day, had an effect on the adequacy of enteral nutrition delivery and the amount of calories and protein in ICU patients.
Findings in the study were published in the journal Nutrition in Clinical Practice. Mechanically ventiliated patients in a St. Louis-based surgical trauma ICU hospital unit were studied using the standard EN feeding practice and a volume-based system called the FEED ME (Feed Early Enteral Diet adequately for Maximum Effect) protocol, and results of both patient pools were compared.
Researchers found the FEED ME protocol significantly increased the proportion of EN volume and calories delivered to patients, and also resulted in increased protein and body weight.
A change in standard of practice to an EN volume-based feeding approach in a STICU led to a significant improvement in adequacy of calories and protein delivered, with only a slight increase in diarrhea, the authors wrote.