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Factors Causing Interrupted Delivery of Enteral Nutrition in Trauma Intensive Care Unit Patients

Laurie M. Morgan, RN, Roland N. Dickerson, PharmD, BCNSP^*,, Kathryn H. Alexander, MS, RD, Rex O. Brown, PharmD, BCNSP^*, and Gayle Minard, MD^,

^* Departments of Pharmacy and Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee; and Nutritional Support Service, Regional Medical Center at Memphis, Memphis, Tennessee

Correspondence: Roland N. Dickerson, PharmD, The University of Tennessee Health Science Center, 26 South Dunlap St., Memphis, TN 38163.

Background: The intent of this study was to ascertain the adequacy of delivery of enteral nutrition (EN) to critically ill adult multiple trauma patients and to identify potential detrimental factors that affect EN delivery. Methods: Retrospective observational study. Trauma intensive care unit (TICU) in a university-affiliated hospital. Adult patients (18 years of age) admitted to the TICU who received enteral feeding. Results: Fifty-six adult patients were enrolled for study. Patients received, on average, 67% ± 19% of what was prescribed for 5.7 ± 2.0 days. A total of 222 occurrences for temporary discontinuation of tube feeding were identified. Gastrointestinal intolerance, as defined by a gastric residual volume of >150 mL, abdominal pain, or >3 liquid stools per day, accounted for only 11% of the occurrences for discontinuation of feeding. Surgery (27%) and diagnostic procedures (15%) represented the majority of reasons for inadequate nutrient delivery. Minor factors for EN interruptions were mechanical feeding tube problems (8%), pharmacy delivery delay (4%), and miscellaneous factors (3%). Multiple and unknown reasons contributed to 14% and 18% of the occurrences, respectively. Conclusions: Surgery and diagnostic procedures accounted for the largest factor in enteral feeding discontinuations in our critically ill trauma patients. Gastrointestinal intolerance contributed a minor role in the temporary discontinuation of enteral feeding.

Nutrition in Clinical Practice, Vol. 19, No. 5, 511-517 (2004)
DOI: 10.1177/0115426504019005511


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