Volume-Based vs Rate-Based Enteral Nutrition in the Intensive Care Unit: Impact on Nutrition Delivery and Glycemic Control

JPEN. Journal of Parenteral and Enteral Nutrition
Susan RobertsLaura Byham-Gray

Abstract

Underfeeding with enteral nutrition (EN) is prevalent in intensive care units (ICUs) and associated with negative outcomes. This study evaluated the impact of volume-based EN (VBEN) vs rate-based EN (RBEN) on delivery of prescribed energy and protein, and glycemic control (GC). This retrospective study included adult patients who require mechanical ventilation within 48 hours of ICU admission and with an RBEN (n = 85) or VBEN (n = 86) order for ≥3 consecutive days during the first 12 ICU days. Patients receiving VBEN, vs RBEN, received more prescribed energy (RBEN, 67.6%; VBEN, 79.6%; P < .001) and protein (RBEN, 68.6%; VBEN, 79.3%; P < .001). Multiple linear regression analyses confirmed VBEN was significantly associated with an 8.9% increase in energy (P = .002) and 7.7% increase in protein (P = .004) received, after adjusting for age, Acute Physiology and Chronic Health Evaluation II score, duration of and initiation day for EN, and ICU admission location. Presence of hyperglycemia (P = .40) and glycemic variability (GV) (P = .99) were not different between the 2 groups. After adjusting for age, body mass index, diabetes history, primary diagnosis, and percent of days receiving corticosteroids, GC outcomes (presence of hyper...Continue Reading

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Citations

Jan 29, 2020·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Tracy BruenLaura Byham-Gray
Sep 19, 2019·JPEN. Journal of Parenteral and Enteral Nutrition·Phillip J PrestChristopher M Watson
Feb 4, 2021·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Nick GoelenPieter Janssen
Apr 2, 2021·Critical Care Nurse·Angela BonomoHee Jun Kim
May 7, 2021·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Sarah J Peterson, Sharon Foley

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