Journal of the Korean Dietetic Association (대한영양사협회학술지)

The Korean Dietetic Association (대한영양사협회)
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Nutritional Assessment of ICU Inpatients with Tube Feeding

경관급식을 공급한 중환자실 환자의 영양상태 평가

  • Kim, Yu-Jin (Dept. of Nutrition Management, Graduate School of Environment & Public Health Studies, Yeungnam University) ;
  • Seo, Jung-Sook (Dept. of Food & Nutrition, Yeungnam University)
  • 김유진 (영남대학교 환경보건대학원 영양관리학과) ;
  • 서정숙 (영남대학교 식품영양학과)
  • Received : 2014.10.07
  • Accepted : 2014.12.19
  • Published : 2015.02.02
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Abstract

This study investigated the general status of tube feeding for intensive care unit (ICU) inpatients and evaluated the consequent nutritional status of patients. This study was approved by the Institutional Review Board (IRB) of a general hospital located in Daegu metropolitan city. The subjects of this study were 80 adult patients who had been admitted to the ICU of a hospital, received fed tube feeding, and then been discharged. The differences in nutrition screening indicators, including percentage ideal body weight (PIBW), serum albumin, hemoglobin, total lymphocyte count, and total cholesterol, before and after tube feeding according to body mass index (BMI) or nutrient feeding levels were investigated. The ratios of actually provided amounts to calorie and protein requirements of patients were $72.8{\pm}15.8%$ and $72.6{\pm}19.8%$, respectively. The change in PIBW before and after tube feeding was significantly different among the BMI groups (P<0.01). The change in hemoglobin concentration before and after tube feeding was also significantly different among the BMI groups (P<0.01). When subjects were divided into three groups (<60%, 60~79%, ${\geq}80%$) according to the ratio of actually provided calories to required calories, there was no significant difference in nutrition screening indicators before and after tube feeding. When the subjects were divided into three groups (<60%, 60~79%, ${\geq}80%$) according to the ratio of actually provided protein to required protein, serum albumin concentration showed a significant difference among the groups before and after tube feeding (P<0.05). Therefore, an intensive nutrition intervention program would be needed for the nutritional improvement of ICU inpatients receiving tube feeding.

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References

  1. Appelboam R, Sair M (2006): Nutrition in the critically ill patient. Anaesth Intensive Care Med 7(4):121-123 https://doi.org/10.1383/anes.2006.7.4.121
  2. Brinson RR, Guild R, Koltz BE (1985): Diarrhea and hypoalbuminemia in intensive care unit. Abstracts of papers Gastroenterology 88(5):1336
  3. Choi MS, Kim JN (1995): A study on nutritional status and support in critically ill patients. J Korean Diet Assoc 1(1):21-30
  4. Chung SS, Lee KS, Kim HS, Kim JN, Lee JH, Lim HS (1995): Comparison of blenderized diets and commercial enteral formulas in the unconscious tube-fed patients. Korean J Nutr 28(4):345-354
  5. De Jonghe B, Appere-De-Vechi C, Fournier M, Tran B, Merrer J, Melchior JC, Outin H (2001): A prospective survey of nutritional support practices in intensive care unit patients:what is prescribed? What is delivered? Crit Care Med 29(1):8-12 https://doi.org/10.1097/00003246-200101000-00002
  6. Delgado-Rodriguez M, Medina-Cuadros M, Gomez-Ortega A, Martinez-Gallego G, Mariscal-Ortiz M, Martinez-Gonzalez MA, Sillero-Arenas M (2002): Cholesterol and serum albumin levels as predictors of cross infection, death, and length of hospital stay. Arch Surg 137(7):805-812 https://doi.org/10.1001/archsurg.137.7.805
  7. Han KH (1992): A study on tube feeding practices of adult in-patients. Korean J Nutr 25(7):668-683
  8. Heyland D, Cook DJ, Winder B, Brylowski L, Van deMark H, Guyatt G (1995): Enteral nutrition in the critically ill patient:a prospective survey. Crit Care Med 23(6):1055-1060 https://doi.org/10.1097/00003246-199506000-00010
  9. Heyland DK, Dhaliwal R, Drover JW, Gramlich L, Dodek P; Canadian Critical Care Clinical Practice Guidelines Committee (2003): Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients. JPEN J Parenter Enteral Nutr 27(5):355-373 https://doi.org/10.1177/0148607103027005355
  10. Kang HJ, Shanmugam S, Yong CS, Kim JA, Rhee JD, Yoo BK (2008): Problems associated with the management of nutrition support team in hospitals in Korea. Korean J Clin Pharm 18(1):45-49
  11. Kang JH, Baek HW, Shin DW, Shin DH, Son HJ, Chang SH, Seo YS, Min JH, Lee YA, Mo YH, Kim MY (2010): The outcomes of critically ill patients after following the recommendations of the nutritional support team. J Korean Soc Parenter Enter Nutr 3(1):40-44
  12. Kim HJ (2006): The changes in nutritional status of patients receiving tube feeding in ICU. Masters degree thesis. Seoul National University. pp.24-32
  13. Kim HJ, Kim EM, Lee GJ, Lee JJ, Lim JH, Lee JM, Jeon HJ, Lee HY (2011): Clinical nutrition service at medical centers in Seoul. J Korean Diet Assoc 17(2):176-189
  14. Kim HS, Choi SH, Ham YJ (2009): Nutritional status and indicators of intensive care unit patients on enteral feeding. Korean J Fundam Nurs 16(1):21-29
  15. Kim HY, Jo MS, Jang YA, Won HS, Lee HS, Yang EJ (2010): Clinical nutrition. Shinkwang Publisher. Seoul. pp.24-25
  16. Kim MH (2013): Nutritional screening tool development for inpatient assessment of risk of malnutrition. Masters degree thesis. Ewha Womans University. pp.10-13
  17. Kim YH, Seo AR, Kim MK, Lee YM (1999): Relationship of nutritional status at the time of admission to length of hospital stay (LOS) and mortality: a prospective study based on computerized nutrition screening. J Korean Diet Assoc 5(1):48-53
  18. Lee JH, Cho KH, Rhee BA, Lee SH, Choue R (2002): A study on nutritional status, biochemical parameters, lipid and electrolytes concentrations according to the duration of enteral nutrition tube-feeding. Korean J Nutrition 35(5):512-523
  19. Lee HS, Shin KH, Rha SY, Chung MJ, Song SY, Song SE, Ham HJ, Kim HM (2014): Changes in nutrient intake in patients at nutritional risk. J Korean Diet Assoc 20(4):285-295 https://doi.org/10.14373/JKDA.2014.20.4.285
  20. Lee MJ (2012): Nutrition support, gastric residual volume and nutritional status of patients receiving enteral nutrition feeding. Masters degree thesis. Dong-A University. pp.37-38
  21. Lee RD, Nieman DC (2007): Nutritional assessment. 4th ed. McGraw Hill. Boston. pp.323
  22. Lee SM, Shin JS (1994): A study of nutritional status and incidences of diarrhea by enteral formula and infusion method in ICU tube-fed patients. Korean J Crit Care Med 9(1):23-32
  23. McClave SA, Sexton LK, Spain DA, Adams JL, Owens NA, Sullins MB, Blandford BS, Snider HL (1999): Enteral tube feeding in the intensive care unit: factors impeding adequate delivery. Crit Care Med 27(7):1252-1256 https://doi.org/10.1097/00003246-199907000-00003
  24. McClave SA, Martindale RG, Vanek VW, McCarthy M, Roberts P, Taylor B, Ochoa JB, Napolitano L, Cresci G; A.S.P.E.N. Board of Directors; American College of Critical Care Medicine; Society of Critical Care Medicine (2009): Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr 33(3):277-316 https://doi.org/10.1177/0148607109335234
  25. McWhirter JP, Pennington CR (1994): Incidence and recognition of malnutrition in hospital. BMJ 308(6934):945-948 https://doi.org/10.1136/bmj.308.6934.945
  26. Moon SS, Lim H, Choi JW, Kim DK, Lee JW, Ko S, Kim DC (2009): Analysis of nutritional support status in the intensive care unit. Korean J Crit Care Med 24(3):129-133 https://doi.org/10.4266/kjccm.2009.24.3.129
  27. Na S, Lee H, Koh SO, Park AS, Han AR (2010): Physician compliance with tube feeding protocol improves nutritional and clinical outcomes in acute lung injury patients. Korean J Crit Care Med 25(3):136-143 https://doi.org/10.4266/kjccm.2010.25.3.136
  28. Pablo AM, Izaga MA, Alday LA (2003): Assessment of nutritional status on hospital admission: nutritional scores. Eur J Clin Nutr 57(7):824-831 https://doi.org/10.1038/sj.ejcn.1601616
  29. Park MH, Ahn JO (1998): Study on nutritional status and clinical practice of neurosurgical tube-fed patients. Korean J Community Nutr 3(3):430-439
  30. Park EK (2000): Degree of enteral tube feeding in the intensive care unit and change in nutritional status. Masters degree thesis. Yonsei University. pp.8-20
  31. Park YO, Kang EH, Park SJ, Park MA, Yoon SY, Kim SL, Park JY, Jung YS, Hong SK, Ye BD, Kim KM (2009): A current survey of the gastric residual volume in critically ill patients who are receiving enteral nutrition. J Korean Soc Parenter Enter Nutr 2(1):24-29
  32. Petros S, Engelmann L (2006): Enteral nutrition delivery and energy expenditure in medical intensive care patients. Clin Nutr 25(1):51-59 https://doi.org/10.1016/j.clnu.2005.08.013
  33. Reid C (2006): Frequency of under- and overfeeding in mechanically ventilated ICU patients: causes and possible consequences. J Hum Nutr Diet 19(1):13-22 https://doi.org/10.1111/j.1365-277X.2006.00661.x
  34. Reid CL (2007): Poor agreement between continuous measurements of energy expenditure and routinely used prediction equations in intensive care unit patients. Clin Nutr 26(5):649-657 https://doi.org/10.1016/j.clnu.2007.02.003
  35. Ryu JA, Cho J, Park SB, Lee D, Chung CR, Yang JH, Jeon K, Suh GY, Park CM (2014): Respiratory complications associated with insertion of small-bore feeding tube in critically ill patients. Korean J Crit Care Med 29(2):131-136 https://doi.org/10.4266/kjccm.2014.29.2.131
  36. Sabol VK (2004): Nutrition assessment of the critically ill adult. ACN Clin Issues 15(4):595-606
  37. Seo JS, Lee JH, Yoon JS, Jo SH, Choi YS (2012): Nutritional assessment. 2nd ed. Powerbook. Seoul. pp.22-24, 54, 169-176, 231-236
  38. Song IS (1986): Nutritional assessment. Korean J Gastroenterol 18(1):1-7
  39. Swails WS, Samour PQ, Babineau TJ, Bistrian BR (1996): A proposed revision of current ICD-9-CM malnutrition code definitions. J Am Diet Assoc 96(4):370-373 https://doi.org/10.1016/S0002-8223(96)00101-0
  40. The Korean Dietetic Association (2008): Manual of medical nutrition therapy. The Korean Dietetic Association. Seoul. pp.23-43
  41. The Korean Society of Critical Care Medicine (2013): Guidelines for nutrition support in the adult critically ill patient. The Korean Society of Critical Care Medicine Standardization Committee. Seoul. pp.12-43
  42. Um MH, Park YK, Lee SM, Lee SM, Lee E, Cha JA, Park MS, Lee HS, Rha MY, Lyu ES (2014): Clinical nutrition service in Korean tertiary hospitals and general hospitals: result of nationwide cross-sectional survey. J Korean Diet Assoc 20(3):183-198 https://doi.org/10.14373/JKDA.2014.20.3.183
  43. Waitzberg DL, Caiaffa WT, Correia MI (2001): Hospital malnutrition: the Brazilian national survey (IBRANUTRI): a study of 4000 patients. Nutrition 17(7-8):573-580 https://doi.org/10.1016/S0899-9007(01)00573-1
  44. Yun SH, Kim SJ, Oh EG (2012): Healthcare professional's knowledge, perception and performance on early enteral nutrition for critically ill patients. Korean J Crit Care Med 27(1):36-44 https://doi.org/10.4266/kjccm.2012.27.1.36

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