Characterizing Gastrostomy Tube Feeding Intolerance in the Surgical Intensive Care Unit.

Area of Science:

• Critical Care Medicine
• Surgical Nutrition
• Gastroenterology

Background:

• Feeding intolerance (FI) post-gastrostomy tube (GT) placement is an understudied complication in surgical intensive care unit (ICU) patients.
• FI can significantly impact patient recovery and nutritional status.

Purpose of the Study:

• To determine the incidence of FI in surgical ICU patients after GT placement.
• To compare characteristics of patients with and without FI after GT placement.

Main Methods:

• A retrospective chart review of surgical ICU patients who underwent GT placement between 2020 and 2023.
• FI was defined by the cessation of enteral nutrition (EN) due to specific symptoms (nausea, vomiting, abdominal distention, etc.).
• Statistical analyses compared patient demographics and outcomes between those with and without FI.

Main Results:

• 24.4% of patients (21 out of 86) developed FI after GT placement.
• Vomiting was the most common cause for cessation of EN (42.9%).
• Intolerant patients were significantly younger than those who tolerated EN (median age 35 vs. 57 years).

Conclusions:

• FI occurred in 24.4% of patients previously tolerating EN, indicating a significant incidence.
• Over half of patients with FI required a change in nutrition delivery route, with some needing total parenteral nutrition.
• Recognizing and managing FI is crucial to avoid malnutrition in this vulnerable patient population.