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Volume-based feeding improves nutritional adequacy in surgical patients
Elizabeth D Krebs1, Kelly O'Donnell2, Amy Berry2
1Department of Surgery, The University of Virginia Health System, Charlottesville, VA, USA.
American Journal of Surgery
|May 30, 2018
Summary
Volume-based feeding improved nutritional intake in critically ill surgical patients compared to traditional rate-based methods. This strategy increased calorie and protein delivery, though clinical outcomes require further study.
Area of Science:
- Critical Care Medicine
- Surgical Nutrition
- Quality Improvement
Background:
- Critically ill surgical patients frequently experience inadequate enteral nutrition with standard rate-based feeding.
- Volume-based feeding offers an alternative by adjusting rates to meet a daily goal volume.
Purpose of the Study:
- To compare the effectiveness of volume-based feeding versus rate-based feeding in critically ill surgical patients.
- To assess the impact on nutritional delivery and clinical outcomes.
Main Methods:
- Prospective quality improvement study utilizing a before-and-after design.
- Comparison of 50 patients on volume-based feeding with 49 patients on rate-based feeding in a surgical, trauma, and burn ICU.
- Outcomes measured included nutritional intake, length of stay, infection rates, and mortality.
Main Results:
- The volume-based feeding group achieved a higher proportion of goal calories (84.5% vs. 73.4%) and protein (86.2% vs. 77.4%).
- Increased total daily calories were delivered in the volume-based group (1604 vs. 1356 kcal).
- No significant differences were observed in length of stay, mortality, aspiration, or gastrointestinal intolerance.
Conclusions:
- Volume-based feeding enhances nutritional intake in critically ill surgical patients.
- The study was underpowered to establish definitive differences in clinical outcomes.
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