Enteral nutrition feeding in Chinese intensive care units: a cross-sectional study involving 116 hospitals View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-12

AUTHORS

Juan Xing, Zhongheng Zhang, Lu Ke, Jing Zhou, Bingyu Qin, Hongkai Liang, Xiaomei Chen, Wenming Liu, Zhongmin Liu, Yuhang Ai, Difeng Wang, Qiuhui Wang, Qingshan Zhou, Fusen Zhang, Kejian Qian, Dongpo Jiang, Bin Zang, Yimin Li, Xiaobo Huang, Yan Qu, Yinguang Xie, Donglin Xu, Zhiqiang Zou, Xiangde Zheng, Jianbo Liu, Feng Guo, Yafeng Liang, Qiang Sun, Hongmei Gao, Yang Liu, Ping Chang, Aibin Ceng, Rongli Yang, Gaiqi Yao, Yun Sun, Xiaorong Wang, Yi Zhang, Yichao Wen, Jian Yu, Rongqing Sun, Zhiwei Li, Shiying Yuan, Yunlin Song, Peiyang Gao, Haiyan Liu, Zhaohui Zhang, Yunfu Wu, Biao Ma, Qiang Guo, Feng Shan, Mingshi Yang, Hailing Li, Yuanfei Li, Weihua Lu, Lei Wang, Chuangyun Qian, Zhiyong Wang, Jiandong Lin, Rumin Zhang, Peng Wan, Zhiyong Peng, Yuqiang Gong, Linxi Huang, Guobao Wu, Jie Sun, Yijun Deng, Dongwu Shi, Lixin Zhou, Fachun Zhou, Qindong Shi, Xiaodong Guo, Xueyan Liu, Weidong Wu, Xiangzhong Meng, Liandi Li, Weiwei Chen, Shusheng Li, Xianyao Wan, Zhixin Chao, An Zhang, Liming Gu, Wei Chen, Jinglan Wu, Lihua Zhou, Zhenhuan Zhang, Yibing Weng, Yongshun Feng, Chunli Yang, Yongjian Feng, Sumin Zhao, Fei Tong, Dong Hao, Hui Han, Baocai Fu, Chuanyong Gong, Zhiping Li, Kunlin Hu, Qiuye Kou, Han Zhang, Jie Liu, Chuming Fan, Xin Zhou, Xiumei Chen, Junli Sun, Xuejun Zhou, Bin Song, Cheng Sun, Liyun Zhao, Xinglu Dong, Linlin Zhang, Dafei Tong, Zhiguo Pan, Chuangjie Cai, Donghao Wang, Yingjun Dong, Yuanqi Gong, Zhisong Wu, Xinke Meng, Ping Wang, Weiqin Li

ABSTRACT

BACKGROUND: There is a lack of large-scale epidemiological data on the clinical practice of enteral nutrition (EN) feeding in China. This study aimed to provide such data on Chinese hospitals and to investigate factors associated with EN delivery. METHODS: This cross-sectional study was launched in 118 intensive care units (ICUs) of 116 mainland hospitals and conducted on April 26, 2017. At 00:00 on April 26, all patients in these ICUs were included. Demographic and clinical variables of patients on April 25 were obtained. The dates of hospitalization, ICU admission and nutrition initiation were reviewed. The outcome status 28 days after the day of investigation was obtained. RESULTS: A total of 1953 patients were included for analysis, including 1483 survivors and 312 nonsurvivors. The median study day was day 7 (IQR 2-19 days) after ICU entry. The proportions of subjects starting EN within 24, 48 and 72 h after ICU entry was 24.8% (84/352), 32.7% (150/459) and 40.0% (200/541), respectively. The proportion of subjects receiving > 80% estimated energy target within 24, 48, 72 h and 7 days after ICU entry was 10.5% (37/352), 10.9% (50/459), 11.8% (64/541) and 17.8% (162/910), respectively. Using acute gastrointestinal injury (AGI) 1 as the reference in a Cox model, patients with AGI 2-3 were associated with reduced likelihood of EN initiation (HR 0.46, 95% CI 0.353-0.599; p < 0.001). AGI 4 was significantly associated with lower hazard of EN administration (HR 0.056; 95% CI 0.008-0.398; p = 0.004). In a linear regression model, greater Sequential Organ Failure Assessment scores (coefficient - 0.002, 95% CI - 0.008 to - 0.001; p = 0.024) and male gender (coefficient - 0.144, 95% CI - 0.203 to - 0.085; p < 0.001) were found to be associated with lower EN proportion. As compared with AGI 1, AGI 2-3 was associated with lower EN proportion (coefficient - 0.206, 95% CI - 0.273 to - 0.139; p < 0.001). CONCLUSIONS: The study showed that EN delivery was suboptimal in Chinese ICUs. More attention should be paid to EN use in the early days after ICU admission. More... »

PAGES

229

References to SciGraph publications

Journal

TITLE

Critical Care

ISSUE

1

VOLUME

22

Author Affiliations

  • Nanjing General Hospital of Nanjing Military Command
  • Zhejiang University
  • Henan Provincial People's Hospital
  • Zhongshan People's Hospital
  • Qilu Hospital of Shandong University
  • Nanjing Medical University
  • First Hospital of Jilin University
  • Xiangya Hospital Central South University
  • Guiyang Medical University
  • Wuxi People's Hospital
  • Renmin Hospital of Wuhan University
  • First Affiliated Hospital of Nanchang University
  • Third Military Medical University
  • China Medical University
  • Guangzhou Medical University
  • Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital
  • Qingdao Municipal Hospital
  • Jining First People's Hospital
  • Guangzhou First People's Hospital
  • Fujian Medical University
  • Inner Mongolia People's Hospital
  • Qingdao University
  • Tangshan Gongren Hospital
  • Southern Medical University
  • North China University of Science and Technology Affiliated Hospital
  • Peking University Third Hospital
  • Anhui Medical University
  • Wenzhou Medical College
  • Shaanxi Provincial People's Hospital
  • Second Affiliated Hospital of Dalian Medical University
  • First Affiliated Hospital of Zhengzhou University
  • Wuhan University of Science and Technology
  • Xinjiang Medical University
  • Chengdu University of Traditional Chinese Medicine
  • First Affiliated Hospital of Anhui Medical University
  • Suzhou Municipal Hospital
  • Jining Medical College
  • First Affiliated Hospital of Soochow University
  • Central South University
  • Changsha Central Hospital
  • First Affiliated Hospital of Wannan Medical College
  • Shanxi Medical University
  • Third Hospital of Hebei Medical University
  • First Affiliated Hospital of Fujian Medical University
  • Zhongnan Hospital of Wuhan University
  • Shantou University Medical College
  • Second Xiangya Hospital of Central South University
  • First People's Hospital of Foshan
  • Chongqing Medical University
  • Xi'an Jiaotong University
  • Chinese PLA General Hospital
  • ShenZhen People’s Hospital
  • Shanxi Academy of Medical Sciences
  • Tongji Hospital
  • First Affiliated Hospital of Dalian Medical University
  • Beijing Chao-Yang Hospital
  • Sixth Affiliated Hospital of Kunming Medical University
  • Capital Medical University
  • Inner Mongolia Medical College Hospital
  • Jiangxi Provincial People's Hospital
  • University of Jinan
  • Hebei Medical University
  • Binzhou Medical University
  • Tianjin Nankai Hospital
  • Hunan Provincial People 's Hospital
  • People's Hospital of Guangxi Zhuang Autonomous Region
  • Sun Yat-sen University
  • China Academy of Chinese Medical Sciences
  • Wuhan General Hospital of Guangzhou
  • First People's Hospital of Yunnan Province
  • Luoyang Central Hospital Affiliated to Zhengzhou University
  • The Military General Hospital of Beijing PLA
  • Guangdong Provincial People's Hospital
  • Beijing Hospital of Traditional Chinese Medicine
  • Anhui Provincial Hospital
  • Shenyang First People's Hospital
  • Second Affiliated Hospital of Nanchang University
  • Beijing University of Chinese Medicine
  • Shenzhen Second People's Hospital
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/s13054-018-2159-x

    DOI

    http://dx.doi.org/10.1186/s13054-018-2159-x

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1107133836

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30244686


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    37 schema:description BACKGROUND: There is a lack of large-scale epidemiological data on the clinical practice of enteral nutrition (EN) feeding in China. This study aimed to provide such data on Chinese hospitals and to investigate factors associated with EN delivery. METHODS: This cross-sectional study was launched in 118 intensive care units (ICUs) of 116 mainland hospitals and conducted on April 26, 2017. At 00:00 on April 26, all patients in these ICUs were included. Demographic and clinical variables of patients on April 25 were obtained. The dates of hospitalization, ICU admission and nutrition initiation were reviewed. The outcome status 28 days after the day of investigation was obtained. RESULTS: A total of 1953 patients were included for analysis, including 1483 survivors and 312 nonsurvivors. The median study day was day 7 (IQR 2-19 days) after ICU entry. The proportions of subjects starting EN within 24, 48 and 72 h after ICU entry was 24.8% (84/352), 32.7% (150/459) and 40.0% (200/541), respectively. The proportion of subjects receiving > 80% estimated energy target within 24, 48, 72 h and 7 days after ICU entry was 10.5% (37/352), 10.9% (50/459), 11.8% (64/541) and 17.8% (162/910), respectively. Using acute gastrointestinal injury (AGI) 1 as the reference in a Cox model, patients with AGI 2-3 were associated with reduced likelihood of EN initiation (HR 0.46, 95% CI 0.353-0.599; p < 0.001). AGI 4 was significantly associated with lower hazard of EN administration (HR 0.056; 95% CI 0.008-0.398; p = 0.004). In a linear regression model, greater Sequential Organ Failure Assessment scores (coefficient - 0.002, 95% CI - 0.008 to - 0.001; p = 0.024) and male gender (coefficient - 0.144, 95% CI - 0.203 to - 0.085; p < 0.001) were found to be associated with lower EN proportion. As compared with AGI 1, AGI 2-3 was associated with lower EN proportion (coefficient - 0.206, 95% CI - 0.273 to - 0.139; p < 0.001). CONCLUSIONS: The study showed that EN delivery was suboptimal in Chinese ICUs. More attention should be paid to EN use in the early days after ICU admission.
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