Ted, patients were commenced on prokinetic agents (metaclopramide 10 mg three times daily i.v. and or erythromycin 250 mg i.v.). Despite prokinetic therapy, if still intolerant a TT tube was placed. One hour pre-TT and 4 hours post-TT placement patients received erythromycin (500 mg i.v.). The TT tube was placed according to the manufacturer’s protocol. (The NG tube was also left in situ for aspirate assessment.) Abdominal X-ray was performed 6 hours after initiation of TT placement to confirm location and NJ feeding commenced.Table 1 (abstract P215) Patient groups Percentage Surgical placed patients Medical patients 15/40 APACHE score Surgical patients 20 ?3 Medical patients 19 ?3 Days of NJ feeding Surgical patients 15.0 ?10.4 Medical patients 10.7 ?1.7 Negative TPN days Surgical patients 125 Medical patientsS87.25/Available online http://ccforum.com/supplements/10/SP217 Effects of hypocaloric feeding on clinical outcome in ICU patientsE Casadei, S Scolletta, F Franchi, P Mongelli, P Giomarelli University Hospital, Siena, Italy Critical Care 2006, 10(Suppl 1):P217 (doi: 10.1186/cc4564) Introduction The risk of a severe malnutrition is particularly high in critically ill patients. On the other hand, to administer feeding overcoming the metabolic need should be considered a significant risk factor and not a useful approach in improving the outcome of ICU patients. To this purpose, a hypocaloric nutritional support has been proposed. It may satisfy the patient’s caloric roteic needs, and supply energy enough aimed to avoid the adverse effects of the stress-related metabolic response. The present study aimed to evaluate the nutritional support management in our ICU, and to assess the relative role of the enteral nutritional therapy on morbidity. Methods One hundred and fifty-one out of 194 adult patients admitted to our polyvalent ICU from 1 January 2005 to 30 September 2005 were retrospectively analyzed. Patients younger than 18 years, those requiring a length of stay less than 3 days, patients with an ideal body weight >30 , and those on parenteral nutritional therapy were excluded from the study. The enteral nutritional support contained 55 carbohydrates, 30 lipids and 15 proteins, and was administered by means of either a nasogastric or orogastric probe. The estimated total caloric need for each patient was calculated with the Harris enedict formula. The correction factor of 1.2 was used for patients admitted to the ICU after severe head injury. Multivariate and receiver perating characteristic (ROC) curve analyses were applied. Results The daily average of theoretical kcals provided was 26.4 ?6 kcals, with respect to 21.8 ?3.4 kcals actually administered. Only 22 of patients received the amount of 90 PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/16266907 of the theoretically calculated kcals. The ROC analysis identified a threshold of 70 for the theoretical/administered nutritional support ratio (T/A-NSR) value related to morbidity (the area under curve was 0.76; 95 CI = 0.681?.843, P < 0.05). By using the threshold of 70 for the T/A-NSR value, we were able PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/6376457 to split our patient population into two groups: group A, patients receiving a T/A-NSR value 70 , and group B receiving a T/A-NSR value >70 . The statistical analysis showed that morbidity, duration of mechanical ventilation, and ICU length of stay were higher in group A (P < 0.05). Conclusion Our findings showed that administering a lower nutritional support (i.e. hypocaloric nutritional support) than the theoretically calcul.
