Critical Care volume 14 , Article number: R37 Cite this article. Metrics details. The primary aim was to measure the amount of nutrients required, prescribed and actually administered in critically ill patients. Secondary aims were to assess adherence to clinical practice guidelines, and investigate factors leading to non-adherence. Observational, multicenter, prospective study, including patients in a total of 19 intensive care units in France.
Clinical factors suspected to influence enteral nutrition were analyzed by univariate and multivariate analysis. Among the variables tested hospital type, use of a local nutrition protocol, sedation, vasoactive drugs, number of interruptions of enteral nutrition and measurement of gastric residual volume , only measurement of residual volume was significant by univariate analysis.
The translation of clinical research and recommendations for enteral nutrition into routine bedside practice in critically ill patients receiving mechanical ventilation was satisfactory, but could probably be improved with a multidisciplinary approach.
Nutritional support is now considered as a standard of care for intensive care unit ICU patients and has been the first-line choice for more than two decades [ 1 ]. The generally accepted goals of nutritional delivery in critically ill patients are to provide nutritional therapy consistent with the patient's condition, prevent nutrient deficiencies, avoid complications related to nutrition delivery, and improve patient outcome [ 2 ]. Unfortunately, a number of factors render the provision of optimal enteral nutrition difficult, such as insufficient caloric targets, gastrointestinal dysfunction such as vomiting and diarrhea, repeated procedures and surgeries associated with interruption of enteral nutrition, feeding tube displacement, inadequate routine nursing procedures with delayed administration of the enteral feed, or premature enteral nutrition withdrawal [ 4 β 6 ].
The implementation of feeding protocols has been proposed as a strategy to optimize adequate delivery of nutritional support [ 7 , 8 ]. Despite a number of corrective measures proposed in recent years, exclusive enteral nutrition in ICU patients remains associated with nutritional deficiencies, and is correlated with impaired short- and long-term clinical outcomes [ 9 , 10 ]. To assess the translation of recommendations [ 1 β 3 , 7 , 8 ] into routine critical care, we measured the amount of nutrients required, prescribed and actually delivered in critically ill patients.
