[The contamination of enteral nutrition in critical patients]

Some previous studies have shown that administration of contaminated enteral diets may produce nosocomial infections in critical patients. There is a series of factors in these patients which may enhance the risk of clinical complications deriving from the administration of enteral nutrition (EN) contaminated by microorganisms (alteration of the immunological state, increased stomach pH, reduced intestinal motility, reduced mucosa production, etc.). This study examines EN contamination in critical patients admitted to the ICU of the Hospital Universitario de Traumatología y Rehabilitación de las C. S. Vall d'Hebron, suffering from cranial-encephalic traumatism and/or multiple traumatism. The data made it possible to create a working design which takes account of factors which may increase the risk of EN contamination. The work was done in three phases, involving different handling procedures (Phase 1, Phase 2 and Phase 3). The results of the three studies made it possible to describe a working method in which the following points are outstanding: handwashing with antiseptic soap prior to handling the EN, avoidance of reuse of containers (if necessary) for more than 24 hours, not to exceed 8 hours' perfusion of EN previously handled, and not to wash the container prior to adding new quantities of EN.