Enteral nutrition in 6 Malaysian intensive care units: a point prevalence study of prescription practices

Introduction: Enteral nutrition (EN) is the first line of nutrition therapy for critically ill patients with an intact gastrointestinal tract. Even though intensive care units (ICUs) generally have established feeding protocols, prescribing practices to achieve nutrition goal is still widely variabl...

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Main Authors: Azahar, Aizad, Ibrahim, Noor Airini, Lim, Thiam Aun
Format: Article
Language:English
Published: International Islamic University Malaysia 2020
Online Access:http://psasir.upm.edu.my/id/eprint/88827/
http://psasir.upm.edu.my/id/eprint/88827/1/EN.pdf
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author Azahar, Aizad
Ibrahim, Noor Airini
Lim, Thiam Aun
author_facet Azahar, Aizad
Ibrahim, Noor Airini
Lim, Thiam Aun
author_sort Azahar, Aizad
building UPM Institutional Repository
collection Online Access
description Introduction: Enteral nutrition (EN) is the first line of nutrition therapy for critically ill patients with an intact gastrointestinal tract. Even though intensive care units (ICUs) generally have established feeding protocols, prescribing practices to achieve nutrition goal is still widely variable among intensive care practitioners. The aim of this study was mainly to investigate commonly prescribed types and energy concentration in EN formulations including protein prescription. Materials and methods: This was an observational, point prevalence study, involving six level 3 ICUs in Malaysia. All patients aged type of EN formulation and protein prescription recorded. RESULTS: A total of 109 patients were included in the analysis out of which 78% of them were mechanically ventilated. At the point of the study, more than 16 years of age in the participating ICUs on the 11th of October 2016 were enrolled in this study and 71.5% (78/109) received EN. Among the EN group, 68% (53/78) received standard formulation feeds (1kcal/ml) while the rest received energy dense formulation (>1kcal/ml). Fluid restriction was the main indication for energy dense formulation prescription, occurring in almost all (24/25) of the patients. There was no report of feeding intolerance. Only 2/109 received parenteral nutrition (PN) giving the EN to PN ratio of 30:1. The mean protein prescription was 0.9g/kg (SD± 0.4). Conclusion: Prescription of EN was 30 times more frequent than PN in these ICUs. In those receiving EN, standard formulation feed was 3 times more commonly prescribed than energy dense feeds with fluid restriction being the main indication of the latter. Protein prescription was less than the guideline recommendation.
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spelling upm-888272021-10-05T22:51:03Z http://psasir.upm.edu.my/id/eprint/88827/ Enteral nutrition in 6 Malaysian intensive care units: a point prevalence study of prescription practices Azahar, Aizad Ibrahim, Noor Airini Lim, Thiam Aun Introduction: Enteral nutrition (EN) is the first line of nutrition therapy for critically ill patients with an intact gastrointestinal tract. Even though intensive care units (ICUs) generally have established feeding protocols, prescribing practices to achieve nutrition goal is still widely variable among intensive care practitioners. The aim of this study was mainly to investigate commonly prescribed types and energy concentration in EN formulations including protein prescription. Materials and methods: This was an observational, point prevalence study, involving six level 3 ICUs in Malaysia. All patients aged type of EN formulation and protein prescription recorded. RESULTS: A total of 109 patients were included in the analysis out of which 78% of them were mechanically ventilated. At the point of the study, more than 16 years of age in the participating ICUs on the 11th of October 2016 were enrolled in this study and 71.5% (78/109) received EN. Among the EN group, 68% (53/78) received standard formulation feeds (1kcal/ml) while the rest received energy dense formulation (>1kcal/ml). Fluid restriction was the main indication for energy dense formulation prescription, occurring in almost all (24/25) of the patients. There was no report of feeding intolerance. Only 2/109 received parenteral nutrition (PN) giving the EN to PN ratio of 30:1. The mean protein prescription was 0.9g/kg (SD± 0.4). Conclusion: Prescription of EN was 30 times more frequent than PN in these ICUs. In those receiving EN, standard formulation feed was 3 times more commonly prescribed than energy dense feeds with fluid restriction being the main indication of the latter. Protein prescription was less than the guideline recommendation. International Islamic University Malaysia 2020 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/88827/1/EN.pdf Azahar, Aizad and Ibrahim, Noor Airini and Lim, Thiam Aun (2020) Enteral nutrition in 6 Malaysian intensive care units: a point prevalence study of prescription practices. International Medical Journal Malaysia, 19 (2). 59 - 65. ISSN 1823-4631 https://journals.iium.edu.my/kom/index.php/imjm/article/view/1565 10.31436/imjm.v19i2.1565
spellingShingle Azahar, Aizad
Ibrahim, Noor Airini
Lim, Thiam Aun
Enteral nutrition in 6 Malaysian intensive care units: a point prevalence study of prescription practices
title Enteral nutrition in 6 Malaysian intensive care units: a point prevalence study of prescription practices
title_full Enteral nutrition in 6 Malaysian intensive care units: a point prevalence study of prescription practices
title_fullStr Enteral nutrition in 6 Malaysian intensive care units: a point prevalence study of prescription practices
title_full_unstemmed Enteral nutrition in 6 Malaysian intensive care units: a point prevalence study of prescription practices
title_short Enteral nutrition in 6 Malaysian intensive care units: a point prevalence study of prescription practices
title_sort enteral nutrition in 6 malaysian intensive care units: a point prevalence study of prescription practices
url http://psasir.upm.edu.my/id/eprint/88827/
http://psasir.upm.edu.my/id/eprint/88827/
http://psasir.upm.edu.my/id/eprint/88827/
http://psasir.upm.edu.my/id/eprint/88827/1/EN.pdf