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clinical practice guideline, critical care, enteral nutrition, evidence-based practice, intensive care, mechanical ventilation, protocol



  1. Ellis, Corinne Schultz


ABSTRACT: Background: Although proper diet has been found to play an important role in patient outcomes, studies have shown that intensive care unit patients often receive inadequate nutrition. Moreover, it has been found that critically ill patients who are mechanically ventilated regularly receive even less nutrition. Inadequate nutrition has been associated with impaired immune response, increased susceptibility to infection, poor wound healing, and neuromuscular impairment. These factors lead to prolonged dependence on ventilators, protracted length of stay, and increased morbidity and mortality. This study investigates the use of an enteral nutrition (EN) protocol and its ability to prompt earlier initiation of feedings and more complete nutrition in mechanically ventilated patients to minimize such complications. Methods: In a sample of 51 mechanically ventilated patients admitted to an intensive care unit, percentage of prescribed calories received and percentage of feedings initiated with 24-48 hours of intubation were calculated before and after the initiation of an EN protocol. Results: In the postintervention group (n = 18), 83.3% received EN with the first 24-48 hours after intubation, compared with 54.5% in the preintervention group (n = 33). In the postintervention group, 77.8% received at least 60% of their prescribed feeding goal compared with 63.6% of the preintervention group. Conclusion: Findings show that the use of an EN protocol when caring for mechanically ventilated patients leads to earlier initiation of feedings as well as more complete nutrition.