Background: The objective of the present study was to evaluate during one year the total delivery of volume, calories, and proteins and compare them with the total prescribed to ICU patients using ENT (Enteral Nutrition Therapy) exclus ively. Methods: Data on the prescribed or infused volume, calories, and protein, as well as their respective needs for each individual, were collect ed. Anthropometric parameters and age data were also collected from the medical records of 41 patients admitted to the intensive care unit. Results: Prescribed versus infused enteral diet volume was presented in 5 weeks which corresponds to the maximum duration of ICU treatment. Regarding sampling, the majority cor responded to elderly people (>64 years old) and males (63.4%). The tot al average prescribed was 719.2 mL of enteral diet on an average of 649.7 mL delivered. In addition, there was no significant difference between the prescribed and delivered volume, caloric value, and protein content of the diet only in the last week of hospitalization, which corresponded to the range of 29 - 36 days. Several factors make it difficult to reach the patient’s caloric and protein recommendations. Most of the reasons are not recorded, corresponding to 57.1%, indicating the difficulty of assessing the inadequacy of the prescribed and delivered volume. Conclusion: To our knowledge, this is the first time that a prescription vs. delivery assessment has been carried out for patients in the Brazilian Midwest. In addition, although our research is a difficulty reported worldwide (in most hospitals), we also provide opportunities for how the problem was solved in our case, which may contribute to other cases.
Boullata, J.I., Carrera, A.L., Harvey, L.,Escuro, A.A., Hudson, L., Mays, A., McGinnis, C., Wessel, J.J., Bajpai, S. and Beebe, M.L. (2017) ASPEN Safe Practices for Enteral Nutrition Therapy. Journal of Parenteral and Enteral Nutrition, 41, 15-103. https://doi.org/10.1177/0148607116673053
McClave, S.A., Taylor, B.E., Martindale, R.G., Warren, M.M., Johnson, D.R., Braunschweig, C., McCarthy, M.S., Davanos, E., Rice, T.W. and Cresci, G.A. (2016) Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN). JPEN. Journal of Parenteral and Enteral Nutrition, 40, 159-211. https://doi.org/10.1177/0148607115621863
Fetterplace, K., Deane, A.M., Tierney, A., Beach, L.J., Knight, L.D., Presneill, J., Rechnitzer, T., Forsyth, A., Gill, B.M. and Mourtzakis, M. (2018) Targeted Full Energy and Protein Delivery in Critically Ill Patients: A Pilot Randomized Controlled Trial (FEED Trial). Journal of Parenteral and Enteral Nutrition, 42, 1252-1262. https://doi.org/10.1002/jpen.1166
Toledo, D. and Castro, M. (2017) Assessment of the Current Outlook of Nutritional Therapy within the Intensive Care Unit. BRASPEN Journal, 32, 297-301.
Grecco, B.H., Araújo-Rossi, P.A. and Nicoletti, C.F. (2022) Nutritional Therapy for Hospitalized Patients with COVID-19: A Narrative and Integrative Review. Journal of Intensive Medicine, 2, 249-256. https://doi.org/10.1016/j.jointm.2022.04.004
Singer, P. (2019) Preserving the Quality of Life: Nutrition in the ICU. Critical Care, 23, Article No. 139. https://doi.org/10.1186/s13054-019-2415-8
Nachvak, S.M., Hedayati, S., Hejazi, N., Motamedi-Motlagh, A. and Abdollahzad, H. (2018) Nutritional Care and Balance of Energy in Patients Hospitalized in Iranian Intensive Care Units. Nutrition Clinique et Métabolisme, 32, 122-128. https://doi.org/10.1016/j.nupar.2018.03.003
Qi, D., Yu, B., Huang, J. and Peng, M. (2018) Meta-Analysis of Early Enteral Nutrition Provided within 24 Hours of Admission on Clinical Outcomes in Acute Pancreatitis. Journal of Parenteral and Enteral Nutrition, 42, 1139-1147. https://doi.org/10.1002/jpen.1139
Bischoff, S.C., Austin, P., Boeykens, K., Chourdakis, M., Cuerda, C., Jonkers-Schuitema, C., Lichota, M., Nyulasi, I., Schneider, S.M. and Stanga, Z. (2020) ESPEN Guideline on Home Enteral Nutrition. Clinical Nutrition, 39, 5-22. https://doi.org/10.1016/j.clnu.2019.04.022
Osuna-Padilla, I., Rodríguez-Moguel, N.C., Aguilar-Vargas, A. and Rodríguez-Llamazares, S. (2021) Safety and Tolerance of Enteral Nutrition in COVID-19 Critically Ill Patients, A Retrospective Study. Clinical Nutrition ESPEN, 43, 495-500. https://doi.org/10.1016/j.clnesp.2021.02.015
Tume, L.N., Valla, F.V., Joosten, K., Jotterand Chaparro, C., Latten, L., Marino, L.V., Macleod, I.,Moullet, C., Pathan, N. and Rooze, S. (2020) Nutritional Support for Children during Critical Illness: European Society of Pediatric and Neonatal Intensive Care (ESPNIC) Metabolism, Endocrine and Nutrition Section Position Statement and Clinical Recommendations. Intensive Care Medicine, 46, 411-425. https://doi.org/10.1007/s00134-019-05922-5
Berger, M.M.,Reintam-Blaser, A., Calder, P.C., Casaer, M., Hiesmayr, M.J., Mayer, K., Montejo, J.C., Pichard, C., Preiser, J.-C. and van Zanten, A.R. (2019) Monitoring Nutrition in the ICU. Clinical Nutrition, 38, 584-593. https://doi.org/10.1016/j.clnu.2018.07.009
Gramlich, L., Hurt, R., Jin, J. and Mundi, M. (2018) Home Enteral Nutrition: Towards a Standard of Care. Nutrients, 10, Article No. 1020. https://doi.org/10.3390/nu10081020
Ojo, O. (2015) The Challenges of Home Enteral Tube Feeding: A Global Perspective. Nutrients, 7, 2524-2538. https://doi.org/10.3390/nu7042524
Santos, D.C.d., Ataide, C.D.G., Mota da Costa, N., Oliveira Junior, V.P.d. and Egea, M.B. (2022) Blenderized Formulations in Home Enteral Nutrition: A Narrative Review about Challenges in Nutritional Security and Food Safety. Nutrition Reviews, 80, 1580-1598. https://doi.org/10.1093/nutrit/nuab121
Bechtold, M.L., Brown, P.M., Escuro, A., Grenda, B., Johnston, T., Kozeniecki, M., Limketkai, B.N., Nelson, K.K., Powers, J. and Ronan, A. (2022) When Is Enteral Nutrition Indicated? Journal of Parenteral and Enteral Nutrition, 46, 1470-1496. https://doi.org/10.1002/jpen.2364
Lu, G.-Y., Xu, H., Li, J.-H., Chen, J.-K. and Ning, Y.-G. (2023) Safety and Outcome of Early Enteral Nutrition in Patients Receiving Extracorporeal Membrane Oxygenation. Clinical Nutrition, 42, 1711-1714. https://doi.org/10.1016/j.clnu.2023.07.021
Delsoglio, M., Pichard, C. and Singer, P. (2020) How to Choose the Best Route of Feeding during Critical Illness. Clinical Nutrition ESPEN, 37, 247-254. https://doi.org/10.1016/j.clnesp.2020.03.019
Kahn, J.M., Le, T., Angus, D.C., Cox, C.E., Hough, C.L., White, D.B., Yende, S. and Carson, S.S. (2015) The Epidemiology of Chronic Critical Illness in the United States. Critical Care Medicine, 43, 282-287. https://doi.org/10.1097/CCM.0000000000000710
Lipschitz, D.A. (1994) Screening for Nutritional Status in the Elderly. Primary Care: Clinics in Office Practice, 21, 55-67. https://doi.org/10.1016/S0095-4543(21)00452-8
Martindale, R., Patel, J.J., Taylor, B., Arabi, Y.M., Warren, M. and McClave, S.A. (2020) Nutrition Therapy in Critically Ill Patients with Coronavirus Disease 2019. Journal of Parenteral and Enteral Nutrition, 44, 1174-1184. https://doi.org/10.1002/jpen.1930
Saand, A.R., Flores, M., Kewan, T., Alqaisi, S., Alwakeel, M., Griffiths, L., Wang, X., Han, X., Burton, R. and Al-Jaghbeer, M.J. (2021) Does Inpatient Hyperglycemia Predict a Worse Outcome in COVID-19 Intensive Care Unit Patients? Journal of Diabetes, 13, 253-260. https://doi.org/10.1111/1753-0407.13137
Wolff, J.L., Starfield, B. and Anderson, G. (2002) Prevalence, Expenditures, and Complications of Multiple Chronic Conditions in the Elderly. Archives of Internal Medicine, 162, 2269-2276. https://doi.org/10.1001/archinte.162.20.2269
Banerjee, D. (2020) The Impact of Covid-19 Pandemic on Elderly Mental Health. International Journal of Geriatric Psychiatry, 35, 1466-1467. https://doi.org/10.1002/gps.5320
Rudnicka, E., Napierala, P., Podfigurna, A., Meczekalski, B., Smolarczyk, R. and Grymowicz, M. (2020) The World Health Organization (WHO) Approach to Healthy Ageing. Maturitas, 139, 6-11. https://doi.org/10.1016/j.maturitas.2020.05.018
Rives-Lange, C., Zimmer, A., Merazka, A., Carette, C., Martins-Bexinga, A., Hauw-Berlemont, C., Guerot, E., Jannot, A., Diehl, J. and Czernichow, S. (2021) Evolution of the Nutritional Status of COVID-19 Critically-Ill Patients: A Prospective Observational Study from ICU Admission to Three Months after ICU Discharge. Clinical Nutrition, 41, 3026-3031. https://doi.org/10.1016/j.clnu.2021.05.007
Pironi, L., Sasdelli, A.S., Ravaioli, F., Baracco, B., Battaiola, C., Bocedi, G., Brodosi, L., Leoni, L., Mari, G.A. and Musio, A. (2021) Malnutrition and Nutritional Therapy in Patients with SARS-CoV-2 Disease. Clinical Nutrition, 40, 1330-1337. https://doi.org/10.1016/j.clnu.2020.08.021
Hiura, G., Lebwohl, B. and Seres, D.S. (2020) Malnutrition Diagnosis in Critically Ill Patients Using 2012 Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition Standardized Diagnostic Characteristics Is Associated with Longer Hospital and Intensive Care Unit Length of Stay and Increased In-Hospital Mortality. Journal of Parenteral and Enteral Nutrition, 44, 256-264. https://doi.org/10.1002/jpen.1599
Del Giorno, R., Quarenghi, M., Stefanelli, K., Capelli, S., Giagulli, A., Quarleri, L., Stehrenberger, D., Ossola, N., Monotti, R. and Gabutti, L. (2020) Nutritional Risk Screening and Body Composition in COVID-19 Patients Hospitalized in an Internal Medicine Ward. International Journal of General Medicine, 13, 1643-1651. https://doi.org/10.2147/IJGM.S286484
Schetz, M., De Jong, A., Deane, A.M., Druml, W., Hemelaar, P., Pelosi, P., Pickkers, P., Reintam-Blaser, A., Roberts, J., Sakr, Y., et al. (2019) Obesity in the Critically Ill: A Narrative Review. Intensive Care Medicine, 45, 757-769. https://doi.org/10.1007/s00134-019-05594-1
Phipps, D. and Helton, M.R. (2023) Obesity and Chronic Disease. In: Daaleman, T.P. and Helton, M.R., Eds., Chronic Illness Care: Principles and Practice, Springer, Berlin, 19-27. https://doi.org/10.1007/978-3-031-29171-5_2
Abhyankar, S., Leishear, K., Callaghan, F.M., Demner-Fushman, D. and McDonald, C.J. (2012) Lower Short- and Long-Term Mortality Associated with Overweight and Obesity in a Large Cohort Study of Adult Intensive Care Unit Patients. Critical Care, 16, R235. https://doi.org/10.1186/cc11903
Memtsoudis, S.G., Bombardieri, A.M., Ma, Y., Walz, J.M., Chiu, Y.L. and Mazumdar, M. (2012) Mortality of Patients with Respiratory Insufficiency and Adult Respiratory Distress Syndrome after Surgery: The Obesity Paradox. Journal of Intensive Care Medicine, 27, 306-311. https://doi.org/10.1177/0885066611411410
Engelen, M.P., van der Meij, B.S. and Deutz, N.E. (2016) Protein Anabolic Resistance in Cancer: Does It Really Exist? Current Opinion in Clinical Nutrition and Metabolic Care, 19, 39-47. https://doi.org/10.1097/MCO.0000000000000236
de Andrade, G.K.P., Carvalho, J.B., do Nascimento, L.A., Rodrigues, A.L.C.C. and Severine, A.N. (2022) Nutritional Assessment Team: Body Composition Assessment Protocol in Hospitalized Patients. Clinical Nutrition Open Science, 42, 119-129. https://doi.org/10.1016/j.nutos.2022.02.006
Seron-Arbeloa, C., Zamora-Elson, M., Labarta-Monzon, L. and Mallor-Bonet, T. (2013) Enteral Nutrition in Critical Care. Journal of Clinical Medicine Research, 5, 1-11. https://doi.org/10.4021/jocmr1210w
Heyland, D.K., Cahill, N.E., Dhaliwal, R., Wang, M., Day, A.G., Alenzi, A., Aris, F., Muscedere, J., Drover, J.W. and McClave, S.A. (2010) Enhanced Protein-Energy Provision via the Enteral Route in Critically Ill Patients: A Single Center Feasibility Trial of the PEP uP Protocol. Critical Care, 14, R78. https://doi.org/10.1186/cc8991
Preiser, J.-C., Arabi, Y.M., Berger, M.M., Casaer, M., McClave, S., Montejo-González, J.C., Peake, S., Reintam Blaser, A., Van den Berghe, G., van Zanten, A., et al. (2021) A Guide to Enteral Nutrition in Intensive Care Units: 10 Expert Tips for the Daily Practice. Critical Care, 25, Article No. 424. https://doi.org/10.1186/s13054-021-03847-4
Lakenman, P., van Schie, J., van der Hoven, B., Baart, S., Eveleens, R., van Bommel, J., Olieman, J. and Joosten, K. (2022) Nutritional Intake and Gastro-Intestinal Symptoms in Critically ill COVID-19 Patients. Clinical Nutrition, 41, 2903-2909. https://doi.org/10.1016/j.clnu.2022.04.001
Hudson, L., Chittams, J., Griffith, C. and Compher, C. (2018) Malnutrition Identified by Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition Is Associated with More 30-Day Readmissions, Greater Hospital Mortality, and Longer Hospital Stays: A Retrospective Analysis of Nutrition Assessment Data in a Major Medical Center. Journal of Parenteral and Enteral Nutrition, 42, 892-897. https://doi.org/10.1002/jpen.1021
Hartl, W.H., Bender, A., Scheipl, F., Kuppinger, D., Day, A.G. and Küchenhoff, H. (2019) Calorie Intake and Short-Term Survival of Critically Ill Patients. Clinical Nutrition, 38, 660-667. https://doi.org/10.1016/j.clnu.2018.04.005
Cutchma, G., EurichMazur, C., Thieme, R.D., De Franca, R.M. and Madalozzo Schieferdecker, M.E. (2016) Fórmulas alimentares: influência no estado nutricional, condicao clínica e complicacoes na terapia nutricional domiciliar. Revista Nutrición Clínica y Dietética Hospitalaria, 36, 45-54.
Ma, Y., Cheng, J., Liu, L., Chen, K., Fang, Y., Wang, G., Zhu, J. and Chen, L. (2021) Intermittent versus Continuous Enteral Nutrition on Feeding Intolerance in Critically Ill Adults: A Meta-Analysis of Randomized Controlled Trials. International Journal of Nursing Studies, 113, Article ID: 103783. https://doi.org/10.1016/j.ijnurstu.2020.103783
Thong, D., Halim, Z., Chia, J., Chua, F. and Wong, A. (2022) Systematic Review and Meta-Analysis of the Effectiveness of Continuous vs Intermittent Enteral Nutrition in Critically Ill Adults. Journal of Parenteral and Enteral Nutrition, 46, 1243-1257. https://doi.org/10.1002/jpen.2324
De Souza, I.A., Bortoletto, M.M., Dias, A.M.N., De Almeida, N.M., Ribeiro, L.C. and Mendonca, E.G. (2018) Nutricao enteral em pacientes oncológicos: Diferencas entre o que é prescrito e administrado. Revista Nutrición Clínica y Dietética Hospitalaria, 38, 31-38.
Yeh, D.D., Fuentes, E., Quraishi, S.A., Cropano, C., Kaafarani, H., Lee, J., King, D.R., DeMoya, M., Fagenholz, P., Butler, K., et al. (2016) Adequate Nutrition May Get You Home. Journal of Parenteral and Enteral Nutrition, 40, 37-44. https://doi.org/10.1177/0148607115585142
Alsharif, D.J., Alsharif, F.J., Aljuraiban, G.S. and Abulmeaty, M.M.A. (2020) Effect of Supplemental Parenteral Nutrition versus Enteral Nutrition Alone on Clinical Outcomes in Critically Ill Adult Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients, 12, Article No. 2968. https://doi.org/10.3390/nu12102968