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Physician Compliance with Tube Feeding Protocol Improves Nutritional and Clinical Outcomes in Acute Lung Injury Patients

 Sungwon Na  ;  Hosun Lee  ;  Shin Ok Koh  ;  Ai Soon Park  ;  A Reum Han 
 Korean Journal of Critical Care Medicine, Vol.25(3) : 136-143, 2010 
Journal Title
Korean Journal of Critical Care Medicine
Issue Date
acute lung injury ; mechanical ventilation ; nutrition status ; protocol compliance ; tube feeding
BACKGROUND: Nutrition delivery is frequently interrupted or delayed by physicians' ordering patterns. We conducted this study to investigate the effect of physician compliance with tube feeding (TF) protocol on the nutritional and clinical outcomes in acute lung injury (ALI) patients. METHODS: After implementing a TF protocol, 71 ALI patients with mechanical ventilation (MV) for > or = 7 days were observed. A dietician assessed the nutritional status of the patients and established individualized nutrition plans according to the protocol. If the physicians followed the dietician's recommendation within 48 hours, the patients were classified under the compliant group (Group 1). RESULTS: Forty patients (56.3%) were classified into Group 1. Prealbumin was comparable in both groups at ICU admission but higher in Group 1 at the time of discharge from the ICU (228 +/- 81 vs 157 +/- 77 mg/dl, p = 0.025). Nitrogen balance was only improved in Group 1. The time to reach calorie goal was shorter and non-feeding days were reduced in Group 1. The proportion of parenteral nutrition to nutritional support days was lower and delivered calories on the 4th and 7th day of TF were higher in Group 1 (p < 0.001). ICU mortality/stay and hospital mortality failed to show differences but hospital stay was prolonged in the noncompliant group (Group 2) (p = 0.023). Arterial oxygen tension and PaO2/FiO2 were maintained during the 1st week of ICU stay in Group 1 but were decreased in Group 2. CONCLUSIONS: Physicians' compliance with the TF protocol contributed to the likelihood of nutritional improvement and a shorter hospital stay in ALI patients with prolonged MV.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Koh, Shin Ok(고신옥)
Na, Sungwon(나성원) ORCID logo https://orcid.org/0000-0002-1170-8042
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