Enteral nutrition in Australian and New Zealand intensive care units: a point-prevalence study of prescription practices.
BACKGROUND
Enteral nutrition (EN) is widely accepted as the preferred method for providing nutrition therapy to critically ill patients. However, optimal energy goals and the best way to achieve those goals are ill defined.


OBJECTIVE
To determine the type and energy concentration of commonly prescribed EN formulations and whether energy-dense formulations (> 1 kcal/mL) are used.


METHODS
Prospective, observational, multicentre, single-day, point-prevalence study.


METHODS
All patients present in 38 Australian and New Zealand intensive care units at 10:00 on 17 November 2010.


METHODS
Demographic data, admission diagnosis and information on EN administration were collected.


RESULTS
522 patients were enrolled. Mean age was 58.7 (SD, 17.3) years, 65% were male and 79% were mechanically ventilated. On study day, 220/522 patients received EN (43%; 95% CI, 39%-48%). ICU admission source, Acute Physiology and Chronic Health Evaluation (APACHE) III diagnostic category, APACHE II score and ventilation on study day predicted receipt of EN. Of those receiving EN, 111/220 (51%; 95% CI, 44%-57%) received a 1 kcal/mL formulation and the remainder received an energy-dense formulation - 2 kcal/mL, 39/220 (18%; 95% CI, 13%-23%); and 1.5 kcal/mL, 32/220 (15%; 95% CI, 10%-20%). There were no significant predictors for receipt of energy-dense versus 1 kcal/mL EN.


CONCLUSIONS
1 kcal/mL and energy-dense formulations are administered with about equal frequency in Australian and New Zealand ICUs. This finding supports future research into the evaluation of optimal nutritional delivery amounts using EN formulations with differing energy concentrations.
School of Medicine, University of Adelaide, Adelaide, SA, Australia. sandra.peake@health.sa.gov.au
Sandra L
SL
Peake
Marianne J
MJ
Chapman
Andrew R
AR
Davies
John L
JL
Moran
Stephanie
S
O'Connor
Emma
E
Ridley
Patricia
P
Williams
D018806:APACHE; D000328:Adult; D000368:Aged; D001315:Australia; D003422:Critical Care; D003430:Cross-Sectional Studies; D002149:Energy Intake; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010818:Practice Patterns, Physicians'