title: Open versus closed enteral nutrition systems for critically ill adults: is there a difference?
abstract: OBJECTIVE
  To compare the volume, total calories, and protein received by critically ill patients between open and closed enteral nutrition (EN) systems and identify the main reasons for EN discontinuation.
  
  
  METHODS
  A cohort study in which adult patients admitted to the intensive care unit (ICU) were followed-up in two periods: throughout November 2009 with all patients (n = 85) receiving EN using the open system (OS group); and from October 2010 to April 2011 with patients (n = 170) receiving EN using the closed system (CS group). Parametric and nonparametric tests were used to compare the variables, taking into account their distribution.
  
  
  RESULTS
  Demographic and clinical characteristics were similar in both groups. There were minor differences with no statistical significance between groups: more calories/kg were prescribed to the OS group (p < 0.001), and a higher volume (mL/kg, p = 0.002) and protein (g/kg, p = 0.001) were prescribed to the CS group. Fasting, enteral feeding or gastrointestinal problems, and performance of procedures and ICU routines in different frequencies between groups (p = 0.001) led to the discontinuation of EN.
  
  
  CONCLUSIONS
  There was no clinically relevant difference between the volume, energy, and protein intake of EN prescribed and administered in OS and CS groups. Clinical instability, procedures, and ICU routines led to EN discontinuation in both groups.
authors.affiliation: Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. rigatti.stella@gmail.com
authors.forename: Stella Marys Rigatti
authors.initials: SM
authors.lastname: Silva
authors.forename: Michelli Cristina Silva de
authors.initials: MC
authors.lastname: Assis
authors.forename: Carla Rosane de Moraes
authors.initials: CR
authors.lastname: Silveira
authors.forename: Mariur Gomes
authors.initials: MG
authors.lastname: Beghetto
authors.forename: Elza Daniel de
authors.initials: ED
authors.lastname: Mello
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016638:Critical Illness / Q000628:therapy*; D004044:Dietary Proteins; D002149:Energy Intake; D004750:Enteral Nutrition / Q000379:methods*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged
chemical_list: D004044:Dietary Proteins