Effects of nutritional risk assessment combined with individual enteral nutrition management process among critically ill patients

Abstract

Objective To explore the effects of nutritional risk assessment combined with individual enteral nutrition management process among critically ill patients. Methods A total of 220 critically ill patients were selected in ICU at Ningbo First Hospital of Zhejiang Province from January 2016 to January 2017. They were coded according to the order of being admitted and were divided into observation group (n=110) and control group (n=110) with the method of random number table. Patients in control group received routine nutritional support following the doctor's advice involving adopting total protein enteral nutrition powder, evaluating gastric residual volume of patients by nurses at four hours interval, increasing dose of nutritive medium according to patients' conditions. Patients in observation group accepted nutritional risk screening with the evaluation standards of nutrition risk screening 2002 (NRS 2002) after being admitted to department along with gastrointestinal function assessment. And then, the individual enteral nutrition management process was carried out. In this process, doctors were responsible for establishing objectives and schemes of nutritional support including nutrition time, types of nutritive medium and nutritional goal. Besides, nurses executed enteral nutrition schemes, and evaluated the tolerance of enteral nutrition dynamically, and adjusted the velocity and quantity of enteral nutrition liquid. Finally, this research compared the indexes of nutrition and amynology, incidences of gastrointestinal dysfunction and infectious complications and time of being admitted to ICU of patients in two groups. Results There were no statistically significant differences in the indexes of nutrition and amynology on the first day of being admitted of patients in two groups (P>0.05) . The indexes of nutrition and amynology including total serum protein (57.06±3.31) g/L, blood albumin (32.12±1.49) g/L, hemoglobin (118.34±9.34) g/L, IgA (3.24±0.50) g/L, IgG (2.96±0.38) g/L, IgM (1.92±0.17) g/L of patients in observation group were higher than those in control group with significant differences on the seventh day (t=4.01, 3.59, 2.39, 6.06, 4.05, 6.19; P<0.05) . The incidences of gastrointestinal dysfunction and infectious complications were 21.81% and 12.72% in observation group significantly lower than those in control group (χ2=11.89, 8.91; P<0.05) . The time of being admitted to ICU was (10.01±2.28) d in observation group and (13.99±1.91) d in control group with a significant difference (t=9.91, P<0.05) . Conclusions The nutritional risk assessment combined with individual enteral nutrition management process can enhance the overall nutritional level, and effectively improve the nutrition of patients, and reduce the incidence of complications related to enteral nutrition, and promote the rehabilitation of patients. It is worth to be used widely in clinical application. Key words: Nutritional assessment; Enteral nutrition; Critically ill patients