Periprocedural nutrition in the intensive care unit: a pilot study

Area of Science:

• Critical Care Medicine
• Surgical Nutrition
• Intensive Care Unit (ICU) Management

Background:

• Enteral nutrition (EN) delivery in surgical ICUs is frequently suboptimal due to procedural interruptions.
• Maintaining nutritional support during procedures is crucial for patient recovery.
• Current practices often lead to significant caloric deficits.

Purpose of the Study:

• To evaluate the impact of continuing perioperative EN or providing compensatory nutrition on caloric delivery.
• To assess whether enhanced nutritional strategies increase patient morbidity.
• To compare outcomes between patients receiving continuous/compensatory EN and those following traditional nil per os guidelines.

Main Methods:

• A pilot study involving 10 adult surgical ICU patients receiving EN undergoing percutaneous tracheostomy.
• One group maintained perioperative EN or received compensatory nutrition (fed group).
• Comparison with 22 control patients (unfed group) adhering to traditional fasting guidelines.

Main Results:

• The fed group received significantly higher median delivered calories (1706 kcal vs. 588 kcal) and a greater percentage of prescribed calories (92% vs. 34%) on the procedure day.
• Median caloric deficit was substantially lower in the fed group (175 kcal vs. 1133 kcal).
• No significant differences were observed in overall ICU complications, gastrointestinal complications, or infectious complications between the groups.

Conclusions:

• Perioperative and compensatory EN strategies effectively increase caloric delivery in surgical ICU patients.
• These enhanced nutrition protocols were not associated with increased patient morbidity in this pilot study.
• The findings suggest a safe and effective method for improving nutritional support during critical procedures.