ESPEN 2013 - Late breaking abstract submission

Late Breaking Abstract

ESPEN13-1847

IMPACT OF EARLY ENTERAL NUTRITION ON THE OUTCOME OF CRITICALLY ILL CANCER PATIENTS

Y.-A. Cho ^{1 2,*}G.-A. Wie ¹J. Y. Moon ^{2 3}S. S. Cho ^{2 4}J. Y. Kim ⁵S. J. Park ^{2 6}J. M. Lee ^{2 4 5}

¹Department of Clinical Nutrition, ²Nutrition Support Team, ³Department of Pharmacy, ⁴Intensive Care Unit, ⁵Center for Lung Cancer, ⁶Center for Liver Cancer, National Cancer Center, Ilsandong-gu, Goyang-si, Korea, Republic Of

Rationale: Early enteral nutrition(EN) is recommended for critically ill patients.The purpose of this study was to assess the impact of early EN on the clinical outcome of critically ill cancer patients.

Methods: This study was performed as a prospective observational study in the Intensive Care Unit(ICU) of the National Cancer Center from April 2011 to July 2012. Adult patients(≥18 years of age) staying in the ICU for >2days were enrolled(n=159). An analysis was conducted involving patients who received EN and survived(n=50). The patients were divided into two groups according to the time to start of EN:EEN group(n=23), started EN within 48h of admission;DEN group(n=27), started EN after 48h. Demographic and anthropometric data,ICU type,PG-SGA,APACHEⅡ score, and nutritional intake were collected. The primary end points were length of ICU stay(ICU-LOS) and length of mechanical ventilation(MV-length).

Results: Upon admission, the APACHEⅡ score and the distribution of malnutrition(PG-SGA B or C) did not differ between the two groups(21.4±2.9 in EEN vs 20.5±2.5 in DEN, 87% vs 93%). Compared with the DEN group, there were more patients in the EEN group that were in SICU(56% vs 17%; p=0.0056),while there were fewer patients on mechanical ventilation in the EEN group(57% vs 89%; p=0.0093). Nutritional adequacy from EN was higher in the EEN group(69±31% of caloric requirement vs 52±28%; p=0.0450),but overall nutritional adequacy(EN+PN) did not differ between the two groups(70% vs 83%). ICU-LOS was shorter in the EEN group compared with the DEN group(10.4±7.4d vs 19.6±14.4d; p=0.0135) based on multivariate analysis. MV-length was shorter in the EEN group,but the difference was not significant(9.4±6.4d vs 12.4±8.6d).

Conclusion: Early EN is able to increase nutritional adequacy from EN and is associated with improvements in clinical outcomes. Thus, early start of enteral nutrition should be encouraged in critically ill cancer patients.

Disclosure of Interest: None Declared

Keywords: critically illearly enteral nutrition