Seda Kıter

Objective: Intensive care patients are at a high risk of malnutrition due to an oral intake failure. Enteral nutrition (EN) is considered to be the gold standard for such patients. However, even if everything is done properly, it is also known that there may be inconsistency between the calculated calorie requirements and the amount of calories given to the patient. There is no gold standard to minimize the EN interruption. The aim of this study was to determine the main factors involved in the EN cutting in an intensive care unit (ICU). Methods: This study was done prospectively after an ethical approval and patient relatives’ informed consent in 1489 study day of 80 ICU patients between September 2013 and September 2014 were obtained. The causes of the EN interruption were grouped under seven main categories (1. gastrointestinal dysfunction, 2. airway management, 3. tracheoesophageal fistula, 4. diagnostic and surgical reasons, 5. mechanical problems, 6. metabolic and hemodynamic instability, and 7. maintenance and position change). A total of 16 factors with subgroups were determined for analysis. Demographic data, the presence of dialysis, state of consciousness, comorbidities, and calculated calories and calorie intake were recorded. The patient’s caloric needs were calculated on a daily basis using the Harris–Benedict formula. Results: In our study, it was determined that 17.1% of the calories calculated as the EN support could not be applied to patients due to interruptions. The EN interruption factors were found to be the airway management (39.7%), mechanical problems (15.4%), metabolic and hemodynamic instability (14.1%), maintenance and position change (12.8%), and gastrointestinal dysfunction (12.8%). Conclusion: The airway management and enteral feeding tube mechanical problems were the most frequently observed EN interruption factors. The awareness of EN interruption factors is important in preventing this problem.