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2017, Number 1

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RCAN 2017; 27 (1)

State of the hospital enteral nutritional support: Prescription vs. energy requirements

Paz BM, Rose CRMA, Fantinelli A, Lipovetzky V, Delledonne A, Etienne C, Iribarne ME, Mendéz I, Cortina M

Language: Spanish
References: 54
Page: 131-142
PDF size: 358.30 Kb.


ABSTRACT

Rationale: Covering the energy requirements (ER) in the patient subjected to enteral nutritional support (ENS) should be oriented to the preservation of his/her nutritional status. Failures in the infusion of the prescribed volumes of enteral nutrients during the conduction of ENR have been reported. Objectives: To assess if hospital prescription (HP) of ENR covers ER of hospitalized patient. Study design: Cross-sectional, descriptive. Study serie: Twenty-nine patients with ages › 18 years (Males: 69%; Average age: 68.3 ± 16.7 years) assisted at the “Dr. Rodolfo Rossi” Acute General Hospital (La Plata, Argentina) between January 2015 and March 2015 (both included) receiving ENS during 3 (o more) days without interruptions. Material and method: Patient´s ER were estimated by means of the “thumb rule”. Prescribed quantities of the nutrient were calculated from the infusion rate (as mililiters.hour-1) of the enteral nutrient, as it was recorded in the “Therapeutic Prescriptions” sheet of the patient´s clinical chart. Twenty-four hours of continuous, uninterrupted infusion of the enteral nutrient was considered. ER covering was obtained from the HP/ER ratio. ENS scheme was judged as satisfactory if HP/ER ratio ≥ 80%. Results: Average ER were 1,743.6 ± 348.9 Kcal.24 hours-1. Average HP represented only 84.4% of estimated ER. In 68.9% of the instances HP did not satisfied calculated ER. In half plus one of the audited charts prescribed quantities of the enteral nutrient did not surpassed 80.0% of the ER. Conclusions: Prescription of insufficient volumes of enteral nutrient places the patient at an increased risk of malnutrition. Insufficient prescribed volumes might be translated to lower infused volumes. To identify first, and to correct later, failures detected in ENR, as well as to improve interdisciplinary work, is needed.


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