Small Bowel Feeding Research Articles

Electromagnetically Navigated Tube Placement Device for Bedside Placement of Small Bowel Feeding Tube on Patients with Acute Severe Pancreatitis: Comparative Study.

A developing approach for the bedside installation of feeding tubes is the Electromagnetic Navigation-assisted Tube Placement Device (ENTPD). The ENTPD monitors the tip position of feeding tubes when they are inserted into the digestive tract. It aids in the avoidance of airway misalignment and allows placing into the small bowel. Several recent exploratory studies have shown that ENTPD for nasojejunal feeding tube installation can improve success rates, lower costs, and allow for a more rapid beginning of enteral nutrition. The aim of this study was to compare the effect of using an ENTPD for bedside placement of small bowel feeding tubes with blind placement on patients with acute severe pancreatitis and to see how well the electromagnetic navigation trajectory image (ENTI) and X-ray agreed on the location of the tube tip after placement. The study was done prospectively using randomized and single-blind methods. The 65 cases used electromagnetic navigation-assisted placement, and 58 cases were blind placement. For judging the tube tip location, we compared the success rate, median time, number of repeat placements, complications, and agreement of ENTI vs. X-ray. The blind placement group's success rate was 86.21% compared to the ENTPD's 95.38%, P = 0.075. The median time was significantly longer in the blind placement group (116.55 ± 68.62 min vs. 25.37 ±12.63 min, P=0.000); the average number of repeating placements was 3.02 ± 1.21 vs. 1.16 ± 0.31 (Blind placement vs. ENTPD, P = 0.002). It provided a high degree of agreement between ENTI and X-ray after contrast, κ=0.752 [95% confidence interval, 0.67-0.84]. No complications occurred in the two groups. ENTPD was used safely and effectively at the bedside to help patients with acute severe pancreatitis get feeding tubes. It not only improved the high successful rate of placement, decreased the time and reduced the exposure to X-ray, but it was also very convenient for bedside placement because of the portable equipment.

Using an Electromagnetic Guidance System for Placement of Small-Bowel Feeding Tubes to Reduce Feeding Start Times.

Cardiothoracic surgery patients have an increased risk for aspiration and may require enteral access for nutrition. In a cardiothoracic intensive care unit, feeding start times were delayed because of scheduling conflicts with support services. An electromagnetic device (Cortrak 2 Enteral Access System, Avanos Medical) was introduced to allow advanced practice providers (nurse practitioners and physician assistants) to independently establish postpyloric access and reduce dependence on ancillary services. A quality improvement study was performed. Pre- and postimplementation data included order time, service arrival, tube placement time, tube positioning, and feeding start times for 207 placements. Pre- and postimplementation surveys were conducted to evaluate advanced practice provider satisfaction with enteral tube placement practices. Feeding start time for initial placement decreased by 35.5% (15.6 hours to 10 hours); for subsequent placement, by 55.2% (15.5 hours to 7.0 hours). Assistance by support services decreased by 80.4% (before implementation, 100 of 100 placements [100%]; after implementation, 21 of 107 placements [19.6%]; P < .001; ϕ = 0.815). Overall, advanced practice provider satisfaction increased. Most participants said that using the electromagnetic device was faster, nutrition was delivered sooner, and implementation was a valuable practice change. Using an electromagnetic device decreased feeding start times, reduced the need for support services, and increased advanced practice provider satisfaction with small-bowel feeding tube placement practices.

Small bowel feeding: do you pay the price for bypassing the stomach?

Hydration and nutritional support is a vital part of medical care, thus a clear understanding of the optimal approach is vital for medical professionals. This is a particularly pertinent issue for patients admitted to a critical care setting. This article aims to define the advantages and disadvantages of gastric and postpyloric feeding in the critical care setting, thus aiding decision-making for clinicians. Within the article, the main themes covered are those relating to enteral feeding tube placement, the impact of enteral feeding route on ventilator-associated pneumonia, optimization of enteral tube feeding in critical care and the impact that a chosen route may have upon gastrointestinal function. The value of enteral feeding in critical illness is proven beyond doubt and the simplest approach has long been 'if the gut works, use it'. If gastric feeding is not able to be established or is not tolerated then jejunal feeding should be considered as a preferable alternative to parenteral nutrition. Improving access to service or techniques for postpyloric tube placement would assist in optimizing nutritional support in the critical care setting.

Predicting The Feasibility of Small Bowel Feeding in Patients With Generalized Secondary Peritonitis

Finding a simple reproducible routine test is relevant for the determination of post-pyloric feeding tolerance.Aim. To evaluate in a pilot study the usefulness of acetaminophen absorption test with post-pyloric drug administration in patients with generalized secondary peritonitis.Materials and methods. Acetaminophen absorption test was performed in patients with generalized secondary peritonitis. 0.5 g of drug was administered into the lumen of the small intestine through the nasojejunal tube and after 5, 10, 15, 20, 30, 40, 50 and 90 min its blood level was determined. The first group (n=14) of variables was taken from patients whose test was performed immediately after the surgery. The second group results (n=10) were obtained from the same patients who were tested when they were able to absorb &gt;1 l/day of enteral nutrition without signs of intolerance.Results. When comparing the concentration of acetaminophen in the blood after the drug administration into the bowel of patients with peritonitis immediately after surgery and at the time when the assimilation of bowel feeding had become possible, it was found that the most significant differences were detected within the time interval of 5–20 minutes after the drug administration (P&lt;0.001). This time interval is optimal for harvesting blood samples during the acetaminophen test procedure.Conclusion. Bowel absorption of acetaminophen may be informative for predicting the feasibility of adequate post-pyloric enteral feeding of patients with generalized secondary peritonitis.

Developing and Maintaining an RDN‐Led Bedside Feeding Tube Placement Program

Registered dietitian nutritionists (RDNs), like other healthcare professionals, are often searching for ways to improve their skills and advance their practice. One way RDNs have expanded their skills is by learning to place small bowel feeding tubes (SBFTs). However, it is also important that staffing RDNs to place SBFTs makes sense for their institution and their patient population. Although it is unknown how many RDNs place SBFTs, feeding tube placements by RDNs have been in practice for almost 2 decades, and it is within the RDN scope of practice. This article is a review of the literature, including indications for SBFT, possible benefits of RDNs placing SBFTs, development and maintenance of an RDN-led SBFT program, and assessment of clinical and institutional outcomes for this procedure.

The Impact of Small Bowel Feeding Tube Placement Simulation on Perceived Self-Efficacy of Knowledge and Confidence for Dietetics Education

The Impact of Small Bowel Feeding Tube Placement Simulation on Perceived Self-Efficacy of Knowledge and Confidence for Dietetics Education

Dietitians' Evaluation of Clearing Luminal Occlusions of Gunk (DECLOG): A Pilot Feasibility Study.

Tube clogging is the most frequent mechanical complication associated with enteral nutrition. The objective of this study was to assess the efficacy of a protocol incorporating prophylactic use of a declogging system with enhanced patient education and monitoring to proactively reduce the incidence of tube occlusions in the home care setting. A convenient sample of patients discharged from hospital to home enteral nutrition (HEN) was screened for eligibility and randomized to control group (standard care) or study group (standard care with prophylactic protocol and monitoring). Study patients received 4 enzyme declogging kits before discharge and were instructed to administer them every 7 days for 4 weeks. Seventeen of 49 (35%) patients reported tube occlusions. The incidence of tube occlusion in the control group was not statistically different than in the study group (29% vs 39%, P=0.44). There was no difference between the 2 groups for negative tube outcomes, such as tube occlusion (P=0.44), emergency department visit (P=0.24), tube replacement (P=0.99), or hospital readmission (P=0.33). Continuous feeding method (P=0.037), small-bowel feeding tubes (P=0.016), and tube diameter <14 French (P=0.069) were associated with tube occlusions. A prophylactic protocol using an enzyme declogging system did not lessen the likelihood of tube occlusions when compared with standard care. Multiple factors are associated with tube occlusion. More research investigating the use of a declogging system to prevent clogging incidence in patients receiving HEN is warranted.

409 Early Feeding Tube Placement in Burn Patients and the Impact on Nutritional Outcomes

Initiation of early nutrition therapy and providing adequate caloric needs in burn patients has been shown to maintain gut integrity, reduce nosocomial infections, decrease disease severity, and achieve nitrogen balance earlier. Failure to meet nutrition needs impairs wound healing, increases risk for infection, and leads to cellular dysfunction. Our Performance Improvement Program monitors several metrics relating to nutrition. These include the time from admission to the placement of feeding tubes, the time it takes to achieve goal tube feeding rates, and the percentage of daily caloric needs met on all patients that meet the criteria for a feeding tube. We reviewed performance improvement data from January 2016 to December 2017. All patients on a ventilator and admitted during this period were included with the exception of patients extubated within 24 hours of admission to the burn unit. Our feeding tube placement protocol calls for post-pyloric placement of feeding tubes with the rationale of a decreased risk for aspiration and the ability to continue tube feeds in the operating room thus decreasing the incidence of not meeting daily caloric needs. If nursing was unable to advance the feeding tube, the GI service was consulted to complete the procedure. During the review period, we had 596 admissions with 50 feeding tube placements. The mean time from admission to tube placement was 5.5 hours. The mean time from admission to initiation of feeding was 11 hours. The mean time from admission to goal rate achieved was 19.5 hours. The percentage of successful post-pyloric placement of feeding tubes by nursing was 75.5%. The average daily caloric needs met was 100.5%. With early small bowel feeding tube placement, we are able to meet caloric needs quickly and consistently to prevent graft loss, reduce infections, decrease LOS, and contribute to positive patient outcomes. We attribute our success in these nutritional matrices to our vigilant Performance Improvement process. In which all of these matrices are monitored and obstructions to nutrition goals are identified in real-time and resolved.

The chronic intestinal pseudo-obstruction subtype has prognostic significance in patients with severe gastrointestinal dysmotility related intestinal failure

Severe gastrointestinal dysmotility (GID) is a significant cause of chronic intestinal failure (CIF) with unclear benefits of sub-classifying into Chronic Intestinal Pseudo-obstruction (CIPO) and non-CIPO sub-types. We compared outcomes between CIPO and non-CIPO sub-types in a tertiary cohort of patients with CIF resulting from severe GID. Adults with primary GID, commenced on home parenteral nutrition (HPN) over a 16-year period at a national referral centre, were included. All patients satisfied GID clinical criteria which mandated evidence of small bowel involvement either objectively (abnormal antroduodenal manometry) or pragmatically (failure to progress on small bowel feeding). Clinical outcomes including HPN dependency and survival were compared between CIPO and non-CIPO sub-types. Patients with primary GID requiring HPN (n=45, age 38±2, 33 females, 23/45 (51%) CIPO, 22/45 (49%) non-CIPO) were included. Patients with CIPO had more surgical interventions (P=0.03), higher incidence of bacterial overgrowth (P=0.006), greater parenteral energy (P=0.02) and volume requirements (P=0.05). Overall, during a mean 6 years' follow-up, 36/45 (80%) patients remained HPN dependent. Multivariate analyses confirmed that the non-CIPO sub-type (P=0.04) and catheter related blood stream infections/1000 days (P=0.01) were predictive factors for time to discontinuing HPN. Overall 5-year survival on HPN was 85%, with no difference between sub-types (P=0.83). The CIPO sub-type is associated with higher HPN dependency and should be recognized as a separate entity in severe GID. In multidisciplinary settings with continuous close monitoring of risks and benefits, our data confirm HPN is a safe, life-preserving therapy in severe GID related CIF.

Clinical Simulation Learning for Small-Bowel Feeding Tube Insertion.

Clinical simulation training provides a realistic environment for students and healthcare professionals to strengthen and broaden skills and abilities. This type of learning experience creates a controlled environment in which learners may attain new skills or further develop skills that positively impact patient outcomes. Although few studies exist regarding the use of clinical simulation training and nutrition support practitioners, preliminary data following a small-bowel feeding tube (SBFT) insertion workshop for intensive care unit registered nurses and registered dietitian nutritionists showed potential use in this realm. The purpose of this paper is to provide a basic overview of clinical simulation learning, review literature related to clinical simulation in healthcare, and discuss the recent implementation of a SBFT insertion workshop incorporating clinical simulation learning.

Risk factors of aspiration of gastrointestinal contents in patients with mechanical ventilation in neurosurgical ICU

Objective To explore the high-risk factors of tracheobronchial aspiration of gastric contents of patients in Neurosurgical ICU, so as to provide basis for aspiration prevention as well as related complications. Methods The prospective cohort study was conducted during the patients with mechanical ventilation who were continuously enrolled. The general information and condition of 74 patients from two tertiary hospitals were recorded and their tracheal secretions were collected. The content of pepsin A in airway secretions was determined whether there is an aspiration. Results The incidence rate of aspiration in 74 patients was 39.2%. The chi-square test results showed that the angle of backrest elevation, the rate of enteral nutrition pump, diameter of nasogastric feeding tube, gastric residual volume, airbag pressure, Glasgow score and the use of sedatives were all related to the occurrence of aspiration (χ2/F =30.771, 16.845, 11.471, 9.212, 6.582, 15.664, 11.722, 18.312; P<0.05) . Logistic regression analysis indicated five risk factors related to aspiration, including bed elevation angle, rate of enteral nutrition pump speed, airbag pressure, whether the use of sedatives and gastric residual volume. AUC of risk score calculation is 0.994, RR=1.979 (1.351, 2.900) . The risk of patients whose AUC score≥10 was double of patients whose AUC score<10. Conclusions To reduce the incidence of aspiration of gastric contents, for patients without contraindications, angle of backrest greater than 30 degrees, maintaining cuff pressure between 20 and 30 cmH2O, nasogastric feeding rate<25 ml/hour, small bowel feeding rate<45 ml/hour, and GRVs ≥50 ml, gastric feedings and enteral nutrition are recommended; pay attention to patients usingsedative drugs, can also reduce the aspiration rate of gastric contents. Key words: Gastrointestinal contents; Risk factors; Neurosurgery; Intensive care unit; Aspiration

Nutrition Therapy in Critically Ill Patients Following Cardiac Surgery: Defining and Improving Practice.

Malnutrition is a predictor of poor outcome following cardiac surgery. We define nutrition therapy after cardiac surgery to identify opportunities for improvement. International prospective studies in 2007-2009, 2011, and 2013 were combined. Sites provided institutional and patient characteristics from intensive care unit (ICU) admission to ICU discharge for a maximum of 12 days. Patients had valvular, coronary artery bypass graft (CABG) surgery, or combined procedures and were mechanically ventilated and staying in the ICU for ≥3 days. There were 787 patients from 144 ICUs. In total, 120 patients (15.2%) had valvular surgery, 145 patients (18.4%) had CABG, and 522 patients (66.3%) underwent a combined procedure. Overall, 60.1% of patients received artificial nutrition support. For these patients, 78% received enteral nutrition (EN) alone, 17% received a combination of EN and parenteral nutrition (PN), and 5% received PN alone. The remaining 314 patients (40%) received no nutrition. The mean (SD) time from ICU admission to EN initiation was 2.3 (1.8) days. The adequacy of calories was 32.4% ± 31.9% from EN and PN and 25.5% ± 27.9% for patients receiving only EN. In EN patients, 57% received promotility agents and 20% received small bowel feeding. There was no significant relationship between increased energy or protein provision and 60-day mortality. Postoperative cardiac surgery patients who stay in the ICU for 3 or more days are at high risk for inadequate nutrition therapy. Further studies are required to determine if targeted nutrition therapy may alter clinical outcomes.

Gastric Versus Small Bowel Feeding in Critically Ill Adults.

Critically ill patients often require enteral feedings as a primary supply of nutrition. Whether enteral nutrition (EN) should be delivered as a gastric versus small bowel feeding in the critically ill patient population remains a contentious topic. The Society of Critical Care Medicine (SCCM)/American Society for Parenteral and Enteral Nutrition (ASPEN), the European Society for Parenteral and Enteral Nutrition (ESPEN), and the Canadian Clinical Practice Guidelines (CCPG) are not in consensus on this topic. No research to date demonstrates a significant difference between the two feeding routes in terms of patient mortality, ventilator days, or length of stay in the intensive care unit (ICU); however, studies provide some evidence that there may be other benefits to using a small bowel feeding route in critically ill patients. The purpose of this paper is to examine both sides of this debate and review advantages and disadvantages of both small bowel and gastric routes of EN. Practical issues and challenges to small bowel feeding tube placement are also addressed. Finally, recommendations are provided to help guide the clinician when selecting a feeding route, and suggestions are made for future research.

Bedside placement of small-bowel feeding tube in Intensive Care Unit for enteral nutrition.

Enteral nutrition is the preferred mode of nutrition in critically ill patients whenever feasible as it has a number of advantages over parenteral feeding. Both gastric and small-bowel feeding can effectively deliver calories. In patients with gastroparesis, small-bowel feeding can help avoid parenteral feeding. We carried out a retrospective observational study to assess the ability to insert the Tiger 2 tube into the small bowel at the bedside in 25 patients who failed to tolerate gastric feeds. The time taken, rate of successful insertion, and ability to feed these patients using a standardized feeding protocol were noted. Success rate of insertion was 78% and feeding could be established. This method reduced the delays and risks associated with transportation and dependence on other specialties.

Survey of contemporary feeding practices in critically ill children in the Asia-Pacific and the Middle East.

Nutrition is a fundamental component of care of critically ill children. Determining variation in nutritional practices within paediatric intensive care units (PICUs) allows for review and improvement of nutrition practices. The aim was to survey the nutrition practices and perspectives of paediatric intensivists and dieticians in Asia-Pacific and the Middle East. A questionnaire was developed to collect data on (1) the respondent's and institution's characteristics, (2) nutritional assessments and nutrient delivery practices, and (3) the perceived importance and barriers to optimal enteral feeding in the PICU. We analysed 47 responses from 35 centres in 18 different countries. Dedicated dietetic services were only present in 13 (37%) centres and regular nutrition assessments were conducted in only 12 (34%) centres. In centres with dedicated dieticians, we found greater use of carbohydrate, fat additives and special formulas. Two thirds [31 (66%)] of respondents used total fluids to estimate energy requirements. Only 11 (31%) centres utilized feeding protocols. These centres had higher use of small bowel feeding, acid suppressants, laxatives and gastric residual volume thresholds. When dealing with feed intolerance, they were also more likely to start a motility agent. There was also a lack of consensus on when feeding should start and the use of adjuncts. Nutrition practices and barriers are unique in Asia-Pacific and the Middle East and strongly reflect a lack of dietetic services. Future effort should focus on developing a uniform approach on nutrition practices to drive paediatric critical care nutrition research in these regions.

Placement of a Magnetic Small Bowel Feeding Tube at the Bedside.

Current methods of achieving postpyloric enteral access for feeding are fraught with difficulties, which can markedly delay enteral feeding and cause complications. Bedside tube placement has a low success rate, often requires several radiographs to confirm position, and delays feeding by many hours. Although postpyloric enteral tubes can reliably be placed in interventional radiology (IR), this involves greater resource utilization, delays, cost, and inconvenience. We assessed the utility of bedside enteral tube placement using a magnetic feeding tube (Syncro-BlueTube; Syncro Medical Innovations, Macon, GA, USA) as a means to facilitate initial tube placement. We recorded the time to insertion, location of tube, success rate, and need for radiographs in a series of patients given magnetic feeding tubes (n = 46) inserted by our hospitalist service over an 8-month interval. Of the 46 attempted magnetic tube placements, 76% were successfully placed in the postpyloric position, 13% were in the stomach, and 11% could not be placed. In 83% of the magnetic tubes, only 1 radiograph was needed for confirmation. The median time to placement was 12 minutes (range, 4-120 minutes). The use of a magnetic feeding tube can increase the success rate of bedside postpyloric placement, decrease the time to successful placement, and decrease the need for supplemental radiographs and IR.

Elimination of Radiographic Confirmation for Small-Bowel Feeding Tubes in Critical Care

A variety of techniques are used for placement of small-bowel feeding tubes. Standard practice at the study institution is for postpyloric placement using an electromagnetically guided placement device (EMPD). EMPD placement is performed by bedside nurses trained in the placement technique and may reduce radiograph exposures and time to initiation of enteral nutrition. To evaluate how changes in SBFT placement verification procedures in critical care patients-from use of EMPD with radiographic confirmation, to placement verification by using EMPD without radiographic confirmation-influenced successful placement, misinterpretations of locations, and radiographic verification of tube locations. The research was conducted at an 800-bed quaternary care referral hospital located in the Midwest. Nine-hundred four feeding tubes were placed in 632 critical care patients by using bedside EMPD instead of radiographic confirmation as the standard of care. Prospectively collected EMPD audit form data were retrospectively analyzed. Small-bowel (duodenum or jejunum) placement was achieved by bedside nurses in 97.2% of all EMPD placements, with 2.8% placed in the stomach because gastric placement was ordered or small-bowel placement could not be achieved. Radiographic confirmation was required in only 7.7% of placements. No adverse events or pulmonary placements occurred. Use of EMPD technology allowed clinicians to safely and effectively place feeding tubes at the bedside and eliminate radiographs in most cases. EMPD placement was not limited to specialized nurses or teams. This procedure should be easily reproducible in other critical care environments.

A Nutrition Algorithm Incorporating Early Initiation of Nutrition With Higher Feeding Rates, Percentage of Gastric Residual Volume, Small-Bowel Feedings, and Compensatory Nighttime Feeds Leads to Reduced Energy Deficit in Critically Ill Patients

Background/Objective. A discrepancy often emerges between nutritional goals and actual delivery. This study assesses the relationship between energy balance and length of stay (LOS) in surgical intensive care unit (SICU) patients. SICU patients are frequently catabolic and at risk of underfeeding. We set forth to identify if a nutritional algorithm will improve energy delivery and outcomes. Methods. A prospective observational study conducted in surgical critical care patients was performed. After implementation of a nutrition algorithm; demographic data, initiation of feeding, acquiring caloric goal, caloric deficit, LOS, and mortality were recorded. Cumulative energy balance was calculated as energy delivery minus daily target. Data are presented as mean ± standard deviation. Results. In all, 100 patients aged 66 ± 17 years (45% female and 55% male) admitted to the SICU were evaluated. All were nutritionally compromised, with 72% being NPO (nothing by mouth), 9% orally fed, and 9% enterally fed. SICU LOS was 4.9 ± 10.6 days; 60-day mortality was 3%; and time to goal feeding was 13 ± 10 hours. Mean daily energy delivery was 1459 ± 268 kcal/d. Cumulative energy balance was between −6401 ± 6404 kcal, with 12 patients having a &gt;10 000 kcal deficit, 3 patients a &gt;20 000 kcal deficit, and 1 patient a &gt;30 000 kcal deficit. Conclusions. A nutritional algorithm will improve energy delivery and outcomes in critically ill patients. Accumulation of caloric deficit &gt;5000 kcal is associated with increased SICU LOS and hospital LOS. Clinical implications. Nutritional algorithms and caloric deficit calculations are an underused critical care tool. The nutritional algorithm presented allows faster attainment of caloric goals, shorter LOS, and improvement in outcome.

Effects of gastric versus small bowel feeding on hospital acquired pneumonia in critically ill patients: a meta-analysis

To explore whether or not small bowel feeding can reduce the incidence of hospital acquired pneumonia (HAP). The databases of Pubmed, Embase and Web of Science were searched to identify the relevant randomized controlled trials (RCT) from January 1992 to September 2012. Meta analysis was performed to analyze the effects of gastric versus small bowel feeding on HAP. Ten RCTs including 830 patients were retrieved and 6 of which examined the effect of ventilator-associated pneumonia (VAP). In total, the incidence of HAP was 15% (62/407) in bowel feeding group versus 23% (97/423) in gastric feeding group. As compared with gastric feeding, small bowel feeding appeared to significantly reduce the incidence of HAP [RR 0.67, 95%CI(0.51-0.89), P = 0.005; I(2) = 0%)], but did not reduce the mortality [RR 1.08, 95%CI(0.84-1.40), P = 0.54; I(2) = 0%] and the duration of ICU stay [weighted mean difference in 0.04 days, 95%CI(-2.83-2.91), P = 0.98; I(2) = 96%]. Subgroup analysis indicated that small bowel nutrition reduced the incidence of VAP [RR 0.64, 95%CI(0.46-0.90), P = 0.01; I(2) = 9%)], but did not reduce the incidence HAP of non-VAP [RR 0.74, 95%CI(0.45-1.21), P = 0.23; I(2) = 0%)]. Compared with gastric feeding, small bowel feeding can reduce the incidence of HAP, especially VAP, but can not reduce the mortality.

Nutrition Therapy for the Critically Ill Surgical Patient With Aortic Aneurysmal Rupture

Our goal is to define nutrition therapy in critically ill patients after surgical repair of acute ruptured or dissecting aortic aneurysm to identify opportunities for quality improvement. International, prospective studies in 2007-2009 and 2011 were combined. Sites provided institutional and patient characteristics including from intensive care units (ICUs) admission to ICU discharge for a maximum of 12 days. We selected patients with aortic aneurysmal rupture or acute dissection staying in the ICU for ≥ 3 days. There were 104 eligible patients from 72 distinct ICUs analyzed. Overall, 86.5% received artificial nutrition. There were 50.0% patients who received enteral nutrition (EN) only, 29.8% patients received a combination of EN and parenteral nutrition (PN), 6.7% patients received PN only, and 13.5% did not receive any nutrition. The mean time from admission to initiation of EN was 3.0 days (SD ± 2.4 days). The adequacy of calories from nutrition support was 46.8% (range 0%-111%) with a mean of 10.0 kcal/kg/day. Of the total of 83 patients who received EN, 53 patients (63.8%) had interruption of EN. The reasons included fasting, intolerance, patients deemed too sick for enteral feeding, and loss of enteral feeding route. For patients with gastrointestinal intolerance, 3/30 patients (10%) received small bowel feeding and 23/30 patients (76.7%) of patients received motility agents. Postoperative critically ill patients with aortic aneurysmal rupture or acute dissection are at high risk for inadequate nutrition therapy, and there may be inadequate utilization of strategies to improve nutrition uptake.