Ann Clin Nutr Metab.  2023 Apr;15(1):22-29. 10.15747/ACNM.2023.15.1.22.

Comparison of a volume-based feeding protocol with standard feeding for trauma patients in intensive care units in Korea: a retrospective cohort study

• Park J
• Oh Y
• Kwon S
• Lee Jh
• Kim M
• Hwang K
• Choi D
• Kwon J

• KMID: 2541591
• DOI: http://doi.org/10.15747/ACNM.2023.15.1.22

Abstract

Purpose
Although early enteral nutrition for critically ill patients is essential, it is difficult to provide enteral nutrition to trauma patients in early hospitalization stages due to frequent surgeries and examinations. We aimed to identify the effect of achieving early enteral nutrition goals and improving outcomes through a volume-based feeding (VBF) protocol for trauma patients.
Methods
Patients who were admitted to the trauma intensive care units (TICUs) of the Ajou University Hospital from January 2020 to September 2021 and received enteral tube feeding for at least 7 days were studied. An institutionspecific VBF protocol was developed, and nurses were trained in its execution. We retrospectively compared outcomes, such as in-hospital mortality and initial nutritional goal achievement, between the new and standard protocols.
Results
Among 2,935 patients, 109 met the inclusion criteria. Of these, 64 patients received nutrition through VBF, with no feeding intolerance symptoms. The VBF group started enteral nutrition approximately 16.9 hours earlier and group achieved 80% of the target calorie and protein intake approximately one day faster than the control group (n=45). The average calorie supply per body weight per day was 4.9 kcal/kg/day more in the VBF group. An increase of 0.2 g/ kg/day was also observed in protein uptake. However, mortality and adverse hospital events did not differ between the groups.
Conclusion
The VBF protocol for patients admitted to the TICU increased the initial nutrient supply without risk of feeding intolerance, but there was no improvement in major clinical outcomes, including mortality and adverse hospital events.

Keyword

Clinical protocols; Enteral nutrition; Intensive care units; Wounds and injuries