Volume-based feeding improves nutritional adequacy in surgical patients

Abstract

BackgroundCritically ill surgical patients often receive inadequate enteral nutrition using traditional rate-based feeding methods. An alternative strategy is volume-based feeding, in which feeding rates are adjusted to deliver a goal volume per day. MethodsThis prospective quality improvement study in a single surgical, trauma, and burn ICU compared volume-based feeding to rate-based feeding in a before-and-after design. Outcomes included calories and protein delivered, length of stay, infection, and mortality. ResultsA total of 50 patients received volume-based feeding and 49 rate-based feeding. The volume-based group received a higher proportion of goal calories (84.5% vs. 73.4%; p = 0.005) and protein (86.2% vs. 77.4%; p = 0.01), as well as increased total daily calories (1604 vs. 1356 kcal; p = 0.02). There was no difference in length of stay, mortality, aspiration, or gastrointestinal intolerance. ConclusionsVolume-based feeding improved nutritional intake in critically ill surgical patients, although this study was underpowered to determine differences in clinical outcomes.