| The purpose of this study was to examine the adequacy of enteral nutritional intake and the factors affecting its delivery in mechanically ventilated intensive care unit (ICU) patients. A prospective, descriptive design was used to study a convenience sample of 60 patients receiving enteral nutrition at goal rate. Patients were enrolled from intensive care units at 2 study sites. Caloric requirements were determined based upon the Harris-Benedict Equation (HBE). A total of 25 patients were also measured by indirect calorimetry. The enteral volume and kilocalories delivered, residual volumes, stool frequency, and duration of feeding interruptions were recorded for 3 consecutive days after the goal rate had been established.; A statistically significant difference was found between the HBE requirements (M = 2,150, SD = 317) and the average kilocalories received (M = 1,410, SD = 731; 95% confidence interval 573–905, p < .001). Forty-one patients (68.3%) received less than 90% of requirements, 18 (30%) received within 10% of requirements, and 1 patient received more than 110% of required calories. However, for patients with indirect calorimetry measurements (n = 25), there was no significant difference between the measured requirements and mean kilocalories received (p = .337). Multiple linear-regression analysis determined that 70% of the variance in the required kilocalories (per HBE) received was explained by the 5 predictors in the model (F5,53 = 25.335, p < .001, R2 .705). Enteral feedings were often interrupted and the duration of feeding interruptions explained 45% of the variance within the context of the other 4 predictors. A number of factors limited the adequacy of enteral intake, as determined by HBE, which may potentially contribute to complications associated with underfeeding and overfeeding. Noteworthy is that the two methods used to determine nutritional requirements yielded different results related to adequacy of intake. This finding poses additional questions about the accuracy of methods commonly used to determine requirements. The study builds upon existing knowledge and provides direction to future research related to enteral nutrition in mechanically ventilated ICU patients. |
