Asian Nursing Research
Volume 4, Issue 2 , Pages 102-110, June 2010

Adequacy of Nutritional Support and Reasons for Underfeeding in Neurosurgical Intensive Care Unit Patients

  • Hwasoon Kim, RN, PhD

      Affiliations

    • Associate Professor, Department of Nursing, Inha University, Incheon, Korea
    • Corresponding Author InformationCorrespondence to: Hwasoon Kim, RN, PhD, Associate Professor, Department of Nursing, Inha University, 253 Yonghyun-dong, Nam-gu, Incheon 402-751, Korea
    • ,
  • Jeong Ae Shin, RN, MSN

      Affiliations

    • Nurse, Quality Improvement Team, Inha University Hospital, Incheon, Korea
    • ,
  • Jae Youn Shin, RN, BSN

      Affiliations

    • Master's Student, Department of Nursing, Inha University, Incheon, Korea
    • ,
  • Ok Min Cho, RN, BSN

      Affiliations

    • Master's Student, Department of Nursing, Inha University, Incheon, Korea

Received 18 February 2010; received in revised form 30 April 2010; accepted 27 May 2010.

Article Outline

Purpose

The purpose of the study was to identify the adequacy of enteral feeding, and the reason and prevalence of under-nutrition, and to determine the relationships between caloric intake and resulting nutritional parameters among neurosurgical intensive care unit (ICU) patients.

Methods

The participants for this descriptive study were 47 neurosurgical ICU patients who had enteral feeding initiated after ICU admission. Data were collected from the initial day of enteral feeding for 7 days. Data related to enteral feeding, feeding interruptions or delay, prealbumin, and transferrin were collected.

Results

The mean age of the participants was 56.62 years. Twenty-six patients did not receive their feeding formula more than once during 7 days, and 11 had interruptions more than 6 times. The mean number of feeding interruptions was 3.23 (SD = 4.47). On the average, only 76.44% of the estimated energy requirement was provided by enteral feeding to the patients. The frequency of underfeeding was 52.17% with respect to enteral feeding. The most frequent reason for the feeding interruption was observation before and after intubation and extubation, which was unavoidable. The next most common reason was gastrointestinal bleeding, mostly due to old clots or trace, followed by residual volume less than 100 mL. Changes in prealbumin and transferrin levels for 7 days between the underfed and adequately fed groups were not statistically significant.

Conclusion

The management of enteral feeding by nurses was overprotective because of the unpredictable nature of ICU patients in terms of their underlying disease process. The management of feeding intolerance needs to be evidence-based and nurses must consistently follow the protocol that has been supported as a useful measure.

Key Words:  enteral feeding , intensive care unit , neurosurgical procedure , undernutrition

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PII: S1976-1317(10)60010-2

doi:10.1016/S1976-1317(10)60010-2

Asian Nursing Research
Volume 4, Issue 2 , Pages 102-110, June 2010

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