Current status and influencing factors of barriers to enteral feeding of critically ill patients: A multicenter study

Huang, Jingying; Yang, Lili; Zhuang, Yiyu; Qi, Haiou; Chen, Xiangpin; Lv, Kai

doi:10.1111/jocn.14667

Cited by 31 publications

(41 citation statements)

References 29 publications

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“…Most clinical nutrition specialists report that enteral nutrition has multiple advantages over parental nutrition and should be selected whenever the gastrointestinal tract can be used [3][4][5][6][7][8]. Parenteral nutrition is more expensive [6,7,9] and is usually more invasive in comparison to enteral nutrition, exposing patients to greater risks [10]. Notably, there are important clinical reasons for preferring the enteral administration route because of the association of parenteral nutrition with severe complications, including thromboembolism, severe metabolic fluctuations, hyper-or hypoglycemia, hyperlipidemia, blood electrolyte abnormalities, infectious complications [2,7,11,12], and, more controversially [13], a greater risk of "bacterial translocation" [12,[14][15][16][17].…”

Section: Enteral Versus Parenteral Nutritionmentioning

confidence: 99%

“…This increases the risk of septic complications [12,20,25] and compromises intestinal immunocompetence, because the expression and induction of specific immune responses critically depend on the local microenvironment [20,25,28]. These problems are less frequently encountered in patients receiving enteral nutrition [9,12,20,21].…”

Section: Enteral Versus Parenteral Nutritionmentioning

confidence: 99%

“…For these reasons, enteral (rather than parenteral) nutrition is recommended in a wide range of clinical situations, including organ transplantation [11], cancer [29], pancreatitis [3,30], Crohn's disease [31], intestinal resection or inflammation [5], critical disease [3,6,7,9], and the postoperative period [3,8,11,23]. It is also preferred for premature or low-birth-weight infants [12,32], for the elderly, for neurological patients [29,[33][34][35], for patients with anorexia nervosa [29], and for those with AIDS [36].…”

Section: Enteral Versus Parenteral Nutritionmentioning

confidence: 99%

“…However, regardless of their disease, patients on enteral nutrition often show a series of "secondary" symptoms that can be described as gastrointestinal tract reactions to diet administration, including: pain, discomfort, gastric residual volume, delayed gastric emptying, abdominal bloating and cramps, nausea/vomiting, diarrhea [1,4,8,9,12,20,22,32,[33][34][35][36][37][38][39], metabolic disorders [1,12], and, when the enteral nutrition is longer term, ulcers and major weight loss [33,34]. In addition, some patients are unable to tolerate enteral nutrition [9,22], especially pediatric patients [38,39].…”

Section: Problems Associated With Enteral Nutritionmentioning

confidence: 99%

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Enteral Feeding: Brain-Visceral Interactions in the Processing of Nutrients

Palma¹,

Mahía²,

Simon³

et al. 2019

Feed Your Mind - How Does Nutrition Modulate Brain Function Throughout Life?

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Enteral nutrition is often mandatory, especially for patients in vegetative or minimally conscious state. However, its application is nonviable in certain cases due to various adverse effects. Some of these are explained by absence of the cephalic phase of digestion, during which exocrine, endocrine, and motor physiological responses prepare the digestive system to receive, digest, transform, and utilize ingested nutrients. These responses result from the stimulation by nutrients of cephalic sensory systems, mainly in the oropharyngeal cavity, and can also be elicited by food-related thoughts or expectations. The digestive system appears able to rapidly assess the suitability of food and transmit this information to the brain. The vagus nerve and its brainstem relays in the caudal nucleus of the solitary tract (NST) and parabrachial complex appear to participate in the anatomic pathway responsible for this rapid processing. Thus, blockade of the vagus nerve, NST, or external lateral parabrachial region (LPBe) interrupts expression of conditioned taste preferences induced by administration of "predigested" food, while LPBe activation by electric stimulation generates similar preferences to those observed after cephalic food administration. This review may help design enteral diets better adapted to digestive physiology and develop pharmacological interventions against adverse effects of enteral nutrition.

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Section: Enteral Versus Parenteral Nutritionmentioning

confidence: 99%

Section: Enteral Versus Parenteral Nutritionmentioning

confidence: 99%

Section: Enteral Versus Parenteral Nutritionmentioning

confidence: 99%

Section: Problems Associated With Enteral Nutritionmentioning

confidence: 99%

See 2 more Smart Citations

Enteral Feeding: Brain-Visceral Interactions in the Processing of Nutrients

Palma¹,

Mahía²,

Simon³

et al. 2019

Feed Your Mind - How Does Nutrition Modulate Brain Function Throughout Life?

View full text Add to dashboard Cite

show abstract

“…There is a need to conduct randomized control studies in this area of research. Huang et al (2018) conducted a survey to study nurses' perspectives of the barriers to providing enteral nutrition to critical care patients. The cross-sectional descriptive study included registered nurses who had worked in the ICU at least one year and were not nurse interns, advanced study nurses, or nurses rotating through the unit.…”

Section: Barriers To Enteral Nutrition Deliverymentioning

confidence: 99%

Improving the Delivery of Enteral Nutrition in the Neurocritical Care Unit Through the Implementation of a Volume-Base Feeding Protocol

Walsh¹

2019

Preprint

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Neurocritical care patients receiving rate-based enteral nutrition (RBEN) consistently received less than their full prescription of enteral nutrition (EN) volume due to interruptions in feeding. This study investigated the impact of the implementation of a volume-based feeding protocol (VBEN) on the percentage of prescribed volume of EN delivered over the course of patients’ neurocritical care unit (NCCU) length of stay. Aim: The aim of this study was to better meet the nutritional needs of adult neurocritical care patients receiving nutrition through the enteral route. Methods: A retrospective pre and postimplementation chart review was conducted on adult patients with age 18 or greater and less than 90 years with a neurological-related injury or disease process who had EN initiated and delivered for three or more days during their stay in NCCU. Results: Despite no significant differences in characteristics or gastrointestinal complications between the groups, there was a significant increase in the percentage of prescribed EN volume delivered over the course of NCCU stay of 23.15% percentage points in the VBEN group (M = 95.3%, SD 4.92) as compared to the RBEN group (M = 72.15%, SD 10.55, t(27, n=40) = 8.89, p

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Systematic review of clinicians’ knowledge, attitudes, and beliefs about nutrition in intensive care

et al. 2021

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Nutrition is a key component of care for critically ill patients; yet nutrition delivery is below international recommendations. In order to improve nutrition delivery to critically ill patients, an understanding of the barriers that prevent guideline adherence is required. It is known that clinicians' knowledge, attitudes, and beliefs of the role of nutrition may act as a potential barrier to nutrition delivery, but whether this remains true in critical care is unknown. The aim of this systematic scoping review was to summarize the literature exploring the knowledge, attitudes, and beliefs of clinicians around nutrition support in critically ill patients. A search of four online databases (MEDLINE via Ovid, Emcare via Ovid, PsycINFO, and CINAHL via EBSCOhost) was conducted on August 14, 2020, to identify literature that reported on clinicians' knowledge, attitudes, and beliefs of nutrition in adult intensive care patients. Data were extracted on study and participant characteristics, methodology, and key study outcomes related to nutrition. Eighteen articles met eligibility criteria and were included in the review. Key findings included the following: nutrition was seen as a priority that ranked below life-saving interventions; differences in perceived clinician responsibilities exist; common barriers to nutrition delivery included inadequate resourcing, lack of nutrition protocols, and gastrointestinal intolerance; and identified facilitators included nutrition education and the presence of a supportive multidisciplinary team. The implementation of nutrition protocols, enhanced clinical nutrition education, and further clarification of roles and responsibilities pertaining to nutrition may assist in improving nutrition delivery in critical care.

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Current status and influencing factors of barriers to enteral feeding of critically ill patients: A multicenter study

Abstract: The findings of this study can be used to inform future intervention and guidelines aimed at addressing these barriers systematically and improving adherence to critical care nutrition guidelines for the provision of enteral nutrition.

Cited by 31 publications

References 29 publications

Enteral Feeding: Brain-Visceral Interactions in the Processing of Nutrients

Enteral Feeding: Brain-Visceral Interactions in the Processing of Nutrients

Improving the Delivery of Enteral Nutrition in the Neurocritical Care Unit Through the Implementation of a Volume-Base Feeding Protocol

Systematic review of clinicians’ knowledge, attitudes, and beliefs about nutrition in intensive care

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