Clinical risks in intensive care unit: how are things with enteral nutrition?

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Critical conditions often develop on the background of baseline nutritional disorders. The last ones are also aggravated throughout the treatment in intensive care unit. Correction of nutritional status is not always a priority in therapy of multiple organ failure. Clinical risks are often associated with inadequate assessment of baseline nutritional disorders and nutritional needs of patients. Enteral nutrition is preferred as nutritional support in critical conditions. The article examines the main clinical risks arising in enteral nutrition. Clinical risk management is the basis of the treatment process and essential aspect to improve the quality of treatment in ICU patients.

Keywords:

enteral nutrition

clinical risks

critical condition

Authors:

Pasechnik I.N.

Central State Medical Academy RF President Affairs Department

ORCID: 0000-0002-8121-4160

Shchuchko A.A.

Moscow City Clinical Hospital No. 51

Skobelev E.I.

Central State Medical Academy of Administrative Directorate of the President of the Russian Federation;
Moscow City Clinical Hospital No. 51

Received:

04.02.2021

Accepted:

23.02.2021

List of references:

Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, Hiesmayr M, Mayer K, Montejo JC, Pichard C, Preiser JC, van Zanten ARH, Oczkowski S, Szczeklik W, Bischoff SC. ESPEN guideline on clinical nutrition in the intensive care unit. Clinical Nutrition. 2019;38(1):48-79. https://doi.org/10.1016/j.clnu.2018.08.037
Makary MA, Daniel M. Medical error-the third leading cause of death in the US. British Medical Journal. 2016;353:i2139. https://doi.org/10.1136/bmj.i2139
Chiozza ML, Ponzetti C. FMEA: A model for reducing medical errors. Clinica Chimica Acta. 2009;404(1):75-78. https://doi.org/10.1016/j.cca.2009.03.015
Sendlhofer G, Brunner G, Tax C, Falzberger G, Smolle J, Leitgeb K, Kober B, Kamolz LP. Systematic implementation of clinical risk management in a large university hospital: the impact of risk managers. Wiener Klinische Wochenschrift. 2015;127(1-2):1-11. https://doi.org/10.1007/s00508-014-0620-7
Pasechnik IN, Rybintsev VYu, Talyzin PA. Safety of pharmacotherapy: what’s new? Anesteziologiya i Reanimatologiya. 2019;5:47-50. (In Russ.). https://doi.org/10.17116/anaesthesiology201905147
Kondrup J, Rasmussen HH, Hamberg O, Stanga Z; Ad Hoc ESPEN Working Group. Nutritional risk screening (NRS 2002): A new method based on an analysis of controlled clinical trials. Clinical Nutrition. 2003;22(3):321-336. https://doi.org/10.1016/s0261-5614(02)00214-5
Heyland DK, Dhaliwal R, Jiang X, Day AG. Identifying critically ill patients who benefit the most from nutrition therapy: The development and initial validation of a novel risk assessment tool. Critical Care. 2011;15(6):R268. https://doi.org/10.1186/cc10546
van Zanten ARH, De Waele E, Wischmeyer PE. Nutrition therapy and critical illness: practical guidance for the ICU, post-ICU, and long-term convalescence phases. Critical Care. 2019;23(1):368. https://doi.org/10.1186/s13054-019-2657-5
Casaer MP, Mesotten D, Hermans G, Wouters PJ, Schetz M, Meyfroidt G, Van Cromphaut S, Ingels C, Meersseman P, Muller J, Vlasselaers D, Debaveye Y, Desmet L, Dubois J, Van Assche A, Vanderheyden S, Wilmer A, Van den Berghe G. Early versus late parenteral nutrition in critically ill adults. The New England Journal of Medicine. 2011;365(6):506-17. https://doi.org/10.1056/NEJMoa1102662
Pasechnik IN. Nutritional Support for Critically Ill Patients (Review). Obshchaya reanimatologiya. 2020;16 (4):40-59. (In Russ). https://doi.org/10.15360/1813-9779-2020-4-40-59
Koekkoek WACK, van Setten CHC, Olthof LE, Kars JCNH, van Zanten ARH. Timing of PROTein INtake and clinical outcomes of adult critically ill patients on prolonged mechanical VENTilation: The PROTINVENT retrospective study. Clinical Nutrition. 2019;38(2):883-890. https://doi.org/10.1016/j.clnu.2018.02.012
Hartl WH, Kopper P, Bender A, Scheipl F, Day AG, Elke G, Küchenhoff H. Protein intake and outcome of critically ill patients: analysis of a large international database using piece-wise exponential additive mixed models. Critical Care. 2022;26(1):7. https://doi.org/10.1186/s13054-021-03870-5
Sviridov SV, Krylov KYu, Vedenina IV, Rubenas M. The impact of specialized therapeutic nutrition on improving the quality of life and recovery of patients with COVID-19: a prospective open multicenter comparative observational study in two groups. Klinicheskoe pitanie i metabolizm. 2020;1(4):165-177. (In Russ.). https://doi.org/10.17816/clinutr65103
Van den Braak CC, Klebach M, Abrahamse E, Minor M, Hofman Z, Knol J, Ludwig T. A novel protein mixture containing vegetable proteins renders enteral nutrition products non-coagulating after in vitro gastric digestion. Clinical Nutrition. 2013;32(5):765-71. https://doi.org/10.1016/j.clnu.2012.11.016
Liu J, Klebach M, Visser M, Hofman Z. Amino Acid Availability of a Dairy and Vegetable Protein Blend Compared to Single Casein, Whey, Soy, and Pea Proteins: A Double-Blind, Cross-Over Trial. Nutrients. 2019;11(11):2613. https://doi.org/10.3390/nu11112613
Hurt RT, McClave SA, Martindale RG, Ochoa Gautier JB, Coss-Bu JA, Dickerson RN, Heyland DK, Hoffer LJ, Moore FA, Morris CR, Paddon-Jones D, Patel JJ, Phillips SM, Rugeles SJ, Sarav Md M, Weijs PJ, Wernerman J, Hamilton-Reeves J, McClain CJ, Taylor B. Summary points and consensus recommendations from the International Protein Summit. Nutrition in Clinical Practice. 2017;32(1 Suppl):142-151. https://doi.org/10.1177/0884533617693610
Alkhawaja S, Martin C, Butler RJ, Gwadry-Sridhar F. Post-pyloric versus gastric tube feeding for preventing pneumonia and improving nutritional outcomes in critically ill adults. The Cochrane Database of Systematic Reviews. 2015;2015(8):CD008875. https://doi.org/10.1002/14651858.CD008875.pub2
Li Y, Ye Y, Mei Y, Ruan H, Yu Y. Semi-automated ultrasound guidance applied to nasogastrojejunal tube replacement for enteral nutrition in critically ill adults. Biomedical Engineering Online. 2018;17(1):21. https://doi.org/10.1186/s12938-018-0452-1
Wischmeyer P, McMoon MM, Waldron NH, Dye EJ. Successful Identification of Anatomical Markers and Placement of Feeding Tubes in Critically Ill Patients via Camera-Assisted Technology with Real-Time Video Guidance. JPEN: Journal of Parenteral and Enteral Nutrition. 2019;43(1):118-125. https://doi.org/10.1002/jpen.1313
Farsi Z, Kamali M, Butler S, Zareiyan A. The Effect of Semirecumbent and Right Lateral Positions on the Gastric Residual Volume of Mechanically Ventilated, Critically Ill Patients. The Journal of Nursing Research: JNR. 2020;28(4):e108. https://doi.org/10.1097/jnr.0000000000000377
Reignier J, Dimet J, Martin-Lefevre L, Bontemps F, Fiancette M, Clementi E, Lebert C, Renard B. Before-after study of a standardized ICU protocol for early enteral feeding in patients turned in the prone position. Clinical Nutrition. 2010;29(2):210-216. https://doi.org/10.1016/j.clnu.2009.08.004
Gungabissoon U, Hacquoil K, Bains C, Irizarry M, Dukes G, Williamson R, Deane AM, Heyland DK. Prevalence, risk factors, clinical consequences, and treatment of enteral feed intolerance during critical illness. JPEN: Journal of Parenteral and Enteral Nutrition. 2015;39(4):441-448. https://doi.org/10.1177/0148607114526450
Lee Z-Y, Ibrahim NA, Mohd-Yusof B-N. Prevalence and duration of reasons for enteral nutrition feeding interruption in a tertiary intensive care unit. Nutrition. 2018;53:26-33. https://doi.org/10.1016/j.nut.2017.11.014
Segaran E, Barker I, Hartle A. Optimising enteral nutrition in critically ill patients by reducing fasting times. Journal of the Intensive Care Society. 2016;17(1):38-43. https://doi.org/10.1177/1751143715599410
Soguel L, Revelly JP, Schaller MD, Longchamp C, Berger MM. Energy deficit and length of hospital stay can be reduced by a two-step quality improvement of nutrition therapy: The intensive care unit dietitian can make the difference. Critical Care Medicine. 2012;40(2):412-419. https://doi.org/10.1097/CCM.0b013e31822f0ad7
Arney BD, Senter SA, Schwartz AC, Meily T, Pelekhaty S. Effect of Registered Dietitian Nutritionist Order-Writing Privileges on Enteral Nutrition Administration in Selected Intensive Care Units. Nutrition in Clinical Practice. 2019;34(6):899-905. https://doi.org/10.1002/ncp.10259
Ridley EJ, Parke RL, Davies AR, Bailey M, Hodgson C, Deane AM, McGuinness S, Cooper DJ. What Happens to Nutrition Intake in the Post-Intensive Care Unit Hospitalization Period? An Observational Cohort Study in Critically Ill Adults. JPEN: Journal of Parenteral and Enteral Nutrition. 2019;43(1):88-95. https://doi.org/10.1002/jpen.1196
Perry J, Stankorb SM, Salgueiro M. Microbial contamination of enteral feeding products in thermoneutral and hyperthermal ICU environments. Nutrition in Clinical Practice. 2015;30(1):128-133. https://doi.org/10.1177/0884533614541680
Berger MM, Reintam-Blaser A, Calder PC, Casaer M, Hiesmayr MJ, Mayer K, Montejo JC, Pichard C, Preiser JC, van Zanten ARH, Bischoff SC, Singer P. Monitoring nutrition in the ICU. Clinical Nutrition. 2019;38(2):584-593. https://doi.org/10.1016/j.clnu.2018.07.009
Jiang L, Huang X, Wu C, Tang J, Li Q, Feng X, He T, Wang Z, Gao J, Ruan Z, Hong W, Lai D, Zhao F, Huang Z, Lu Z, Tang W, Zhu L, Zhang B, Wang Z, Shen X, Lai J, Ji Z, Fu K, Hong Y, Dai J, Hong G, Xu W, Wang Y, Xie Y, Chen Y, Zhu X, Ding G, Gu L, Zhang M. The effects of an enteral nutrition feeding protocol on critically ill patients: A prospective multi-center, before-after study. Journal of Critical Care. 2020;56:249-256. https://doi.org/10.1016/j.jcrc.2020.01.018
Jenkins B, Calder PC, Marino LV. Evaluation of implementation of fasting guidelines for enterally fed critical care patients. Clinical Nutrition. 2019;38(1):252-257. https://doi.org/10.1016/j.clnu.2018.01.024
Whittaker BA, Gillum DR, Kelly M. Burnout, Moral Distress, and Job Turnover in Critical Care Nurses. International Journal of Studies in Nursing. 2018;3(3):108-121. https://doi.org/10.20849/ijsn.v3i3.516
Honda CK, Freitas FG, Stanich P, Mazza BF, Castro I, Nascente AP, Bafi AT, Azevedo LC, Machado FR. Nurse to bed ratio and nutrition support in critically ill patients. American Journal of Critical Care. 2013;22(6):71-78. https://doi.org/10.4037/ajcc2013610
Cahill NE, Murch L, Cook D, Heyland DK; Canadian Critical Care Trials Group. Barriers to feeding critically ill patients: a multicenter survey of critical care nurses. Journal of Critical Care. 2012;27(6):727-734. https://doi.org/10.1016/j.jcrc.2012.07.006
Kim H, Chang SJ. Implementing an educational program to improve critical care nurses’ enteral nutritional support. Australian Critical Care. 2019;32(3):218-222. https://doi.org/10.1016/j.aucc.2018.04.001
Castro MG, Pompilio CE, Horie LM, Verotti CC, Waitzberg DL. Education program on medical nutrition and length of stay of critically ill patients. Clinical Nutrition. 2013;32(6):1061-1066. https://doi.org/10.1016/j.clnu.2012.11.023

Simegn GD, Bayable SD, Fetene MB. Prevention and management of perioperative hypothermia in adult elective surgical patients: A systematic review. Ann Med Surg (Lond). 2021;72:103059. https://doi.org/10.10167j.amsu.2021.103059

Harvey CJ. Evidence-Based Strategies for Maternal Stabilization and Rescue in Obstetric Hemorrhage. AACNAdv Crit Care. 2018;29(3):284-294. https://doi.org/10.4037/aacnacc2018966

Kander T, Schott U. Effect of hypothermia on haemostasis and bleeding risk: A narrative review. J Int Med Res. 2019;47(8):3559-3568. https://doi.org/10.1177/0300060519861469

Pacagnella RC, Borovac-Pinheiro A. Assessing and managing hypovolemic shock in puerperal women. Best Pract Res Clin Obstet Gynaecol. 2019;61: 89-105. https://doi.org/10.1016/j.bpobgyn.2019.05.012

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