ESPEN 2013 - Late breaking abstract submission
Late Breaking Abstract
ESPEN13-1808
HIGH CALORIC, HIGH PROTEIN ENTERAL TUBE FEEDING IN THE CLINICAL ROUTINE: EVALUATION OF AN APPLICATION SCHEME
C. Paul 1,*K.-H. Vestweber 1
1Department of General, Visceral and Thoracic Surgery, Klinikum, Leverkusen, Germany
Rationale: Critically ill patients (pts) with limited enteral volume tolerance or fluid restriction might benefit from energy and protein dense enteral nutrition (EN). A high-caloric, high protein tube feed was evaluated for gastrointestinal (GI) tolerance and feasibility in routine application in different subgroups of pts with impaired intestinal motility and absorption.
Methods: Open observational study in 25 critically ill pts (8 acute renal failure (ICU)/ dialysis, 8 neurological, 9 after major GI-cancer surgery) receiving an EN formula with 2 kcal/ml and 20 energy% protein (Fresubin® 2 kcal HP fibre) for 7-14 days.
Results: 46/54% of pts were scheduled for EN doses of 500/1000 ml/day, respectively. Compliance was very good (98%). Planned amounts of EN were generally achieved: all pts received ≥500ml/day of the EN formula for ≥7 days; for 1000 ml/day, a build-up phase was initiated. Mean duration of EN was 11.9±2.7 days (mean±SD) given via nasogastric tube (52%), percutaneous endoscopic gastrostomy (20%), or jejunostomy (28%). Average flow rate was 54.4±13.2 ml/h on day 1 and 73.2±18.7 ml/h on day 7 (mean increase in application rate: 18.8 ml/h). Mean EN intake was 626.±221 ml/day delivering 1252±442 kcal/day. During weeks 1 and 2, 84% and 75% of pts reported ≥ 1 GI event, mainly flatulence, bloating, and diarrhoea; only 12 being related to study nutrition. GI-tolerability was rated as equal in 52% and better in 48% of pts compared to historical standard of nutritional care.
Conclusion: The energy and protein dense enteral tube feed could be successfully administered in the planned routine. In various subgroups of severely ill pts, occurrence of GI symptoms was as expected and compared to the preceding nutritional regimen GI-tolerability was improved or maintained, facilitating administration of nutrient-dense EN in the same time frame.
Disclosure of Interest: C. Paul: None DeclaredK.-H. Vestweber Grant / Research Support from: Fresenius Kabi
Keywords: Enteral nutritionVolume restriction