Preventive Strategies for Feeding Intolerance in Patients with Severe Traumatic Brain Injury in China: An Online Cross-Sectional Survey

Abstract

Background The application of preventive strategies for feeding intolerance in severe traumatic brain injury (STBI) patients is discrepant among different hospitals. We aim to investigate the application status of preventive measures of feeding intolerance in China. Method A cross-sectional study was carried out among 996 clinicians and nurses working in intensive care units of 89 hospitals in China (response rate of 89.81%). Data were collected by means of an online survey. Descriptive statistics were used to analyze respondents’ characteristics and questionnaire responses. Results Clinicians and nurses usually applied several methods simultaneously to assess gastrointestinal functions and risk of feeding intolerance among STBI patients, including assessment scales, gastrointestinal symptoms, etc. Furthermore, initiating enteral nutrition (EN) within 24-48 hours (61.45%), < 500 ml initial volume of EN solution (50.00%), using non-nutritional preparations as initial EN formula (65.56%), nasogastric tube EN (91.16%), continuous feeding by pump (72.89%), 30°-45° of head-of-bed elevation during EN (89.46%), monitoring gastric residual volume by syringe (93.67%), assessing gastric residual volume every 4 hours (51.51%), EN solution temperature of 38℃-40℃ (65.46%), prokinetic agents (73.29%), enema (73.59%), probiotics (79.01%), and antacid agents (84.13%), were mostly applied strategies in clinical practice for preventing feeding intolerance among STBI patients. Conclusions The data from the survey showed that medical staffs in China are closely concerned with the gastrointestinal functions of STBI patients and EN delivery protocol, and have a positive attitude towards preventive strategies for feeding intolerance. Meanwhile, there are still many points need to be paid attention to and solved, and researchers, clinicians, nurses and dietitians should strengthen the cooperation to explore more valuable preventive strategies for feeding intolerance in STBI patients.

Intensive care nurses' knowledge and use of a nursing checklist: A cross‐sectional survey

“…In our study, 93.3% of the nurses stated that they had knowledge about the management of ‘water balance and constipation’ and 81.1% of them stated that the monitoring of the parameter was done in their clinics. It has been reported in studies that 69.8% of intensive care patients have thirst (Lin et al, 2022) and 85.04% of them have constipation (Fang et al, 2021). Causes include the severity of the disease, Nil Per Os (NPO), sodium, glucose level and osmolality imbalance, surgery, mechanical ventilation, opioid use and diuretic use (Lin et al, 2022).…”