Critical care 24 × 7: But, why is critical nutrition interrupted?
OBJECTIVE
Adequate nutritional support is crucial in prevention and treatment of malnutrition in critically ill-patients. Despite the intention to provide appropriate enteral nutrition (EN), meeting the full nutritional requirements can be a challenge due to interruptions. This study was undertaken to determine the cause and duration of interruptions in EN.


METHODS
Patients admitted to a multidisciplinary critical care unit (CCU) of a tertiary care hospital from September 2010 to January 2011 and who received EN for a period >24 h were included in this observational, prospective study. A total of 327 patients were included, for a total of 857 patient-days. Reasons and duration of EN interruptions were recorded and categorized under four groups-procedures inside CCU, procedures outside CCU, gastrointestinal (GI) symptoms and others.


RESULTS
Procedure inside CCU accounted for 55.9% of the interruptions while GI symptoms for 24.2%. Although it is commonly perceived that procedures outside CCU are the most common reason for interruption, this contributed only to 18.4% individually; ventilation-related procedures were the most frequent cause (40.25%), followed by nasogastric tube aspirations (15.28%). Although GI bleed is often considered a reason to hold enteral feed, it was one of the least common reasons (1%) in our study. Interruption of 2-6 h was more frequent (43%) and most of this (67.1%) was related to "procedures inside CCU".


CONCLUSIONS
Awareness of reasons for EN interruptions will aid to modify protocol and minimize interruptions during procedures in CCU to reach nutrition goals.
Department of Critical Care Medicine, Apollo Hospitals, Chennai, Tamil Nadu, India.
Nagarajan
N
Ramakrishnan
Department of Dietetics, Apollo Hospitals, Chennai, Tamil Nadu, India.
D K
DK
Daphnee
Department of Critical Care Medicine, Apollo Hospitals, Chennai, Tamil Nadu, India.
Lakshmi
L
Ranganathan
Department of Dietetics, Apollo Hospitals, Chennai, Tamil Nadu, India.
S
S
Bhuvaneshwari
Critical care; enteral nutrition; interruption of feeds; malnutrition