Abstract
Aim To evaluate the impact of evidence-based enteral nutrition (EN) guidelines on nutritional outcomes in critically ill, mechanically ventilated patients. Methods A prospective observational study included an introductory programme for nurses on recent American Society for Parenteral and Enteral Nutrition (ASPEN) nurse-centered guidelines on EN. Bedside observations pre and post-intervention included clinical outcomes, nutritional adequacy, and EN-associated complications. Results A total of 192 patients (80 controls,112 intervention patients) participated. Following implementation of the guidelines, the most significant clinical outcomes included a reduction in gastric residual volume (P=0.001) and change in body weight (P=0.032). Calorie adequacy increased from 8.7% to 55.4% (P<0.001). The incidence of pulmonary aspiration and diarrhoea reduced significantly (P=0.03, P<0.001 respectively). Gender, duration of EN, duration of mechanical ventilation, and acute physiology and chronic health evaluation (APACHE) II score were factors influencing nutritional adequacy. Conclusion Adopting ASPEN guidelines improves nutritional adequacy and clinical outcomes in enterally fed, mechanically ventilated patients.
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