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Association between illness severity and timing of initial enteral feeding in critically ill patients: a

Hsiu-Hua Huang1, Chien-Wei Hsu, Shiu-Ping Kang

  • 1Department of Life Sciences, College of Bioscience and Biotechnology, National Cheng Kung University, No,1, University Rd,, Tainan City 701, Taiwan.

Nutrition Journal
|May 5, 2012
PubMed

Insights

Early enteral nutrition benefits critically ill patients. For those with more severe illness, early feeding improves nutrition but may increase complications and ICU stay, though overall outcomes remain similar.

Area of Science:

  • Critical care medicine
  • Clinical nutrition
  • Patient outcomes

Background:

  • Early enteral nutrition is standard for critical illness but its benefit in extremely ill patients is debated.
  • Investigating the association between illness severity and the timing of enteral feeding initiation is crucial.

Purpose of the Study:

  • To determine the association between illness severity and the commencement of enteral feeding in critically ill patients.
  • To evaluate the impact of early versus late enteral feeding on various clinical outcomes based on illness severity.

Main Methods:

  • A cross-sectional, retrospective observational study of 108 critically ill patients.
  • Patients were categorized as "less severe" or "more severe" using an Acute Physiology and Chronic Health Evaluation II score cutoff of 20.
  • Data on nutritional status, feeding complications, ICU/hospital stay, and mortality were collected for early (within 48 hours) versus late enteral feeding.

Main Results:

  • No significant outcome differences were observed between early and late feeding in less severely ill patients.
  • In more severely ill patients, early feeding was linked to improved serum albumin and prealbumin levels.
  • However, more severe patients on early feeding experienced worsened nitrogen balance, increased feeding complications, and longer ICU stays compared to late feeders.

Conclusions:

  • Illness severity significantly influences the outcomes of early enteral feeding.
  • While early feeding improves nutritional markers in severe illness, it may also increase complications and ICU length of stay.
  • Despite potential complications, early enteral nutrition is a beneficial intervention for critically ill patients with more severe illness, without impacting overall mortality or hospital stay.
Abstract

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