The Impact Of The Early Enteral Nutrition Up To Goal On The Prognosis Of Critical Patients With Different Severity Of Illness

Objective:Early enteral nutrition (EEN) can significantly improve the survival rate of critically ill patients, shorten the length of stay in hospital and reduce the costs of medical care. However, there are still some controversies about EN at present. The criteria of EEN up to goal varies, and many factors can affect EEN up to goal. Furthermore, the impact of EEN up to goal on the prognosis of patients with different severity of illness in ICU isn't confirmed. Therefore, this study is aimed to determine the value of EEN up to goal on the prognosis of these patients in ICU.Methods:There are 192 critically ill patients who met the criteria of enrollment, were included in this study during the past 18 months in our ICU. They were divided by grades as the severity of illness according to APACHEâ…¡scores. The retrospective analysis on the early entral nutrution to check whether the third day of enteral nutrition supply is reach to 60% nutrition goal [25kcal/(kg. d)].So the patients were divided into two groups: Up to goal and Non up to goal . According to APACHEâ…¡scores,the patients were divided into three sub-groups with score inferior to 15 , between 15 and 25 and superior to 25 .Results:According to the criteria of EEN up to goal, 62 patients were in the group of EEN up to goal, and the rest of 130 patients didn't meet the critera. When the scores of APACHEâ…¡was inferior to 15, the length of stay (LOS) in hospital were significantly lower in the group of EEN up to goal, in comparison with that of non EEN up to goal. When the scores of APACHEâ…¡was between 15 and 25, the LOS in ICU (t=3.966,p=0.000), in hospital (t=8.165,p=0.000), the cost of medical care (t=4.812,p=0.000) and the mortality(=5.421,p=0.038) were all significantly lower in patients with EEN up to goal. However, when the scores of APACHEâ…¡was superior to 25, only the cost of medical care (t=7.364,p=0.000) was significantly lower in patients of EEN up to goal than that of non EEN up to goal .Conclusions:The EEN up to goal can significantly increase the survival rate of critically ill patients, shorten the LOS in hospital and reduce the cost of medical care, when the patients with APACHEâ…¡scores between 15 and 25. So the clinical value of EEN up to goal varies depending on the severity of illness.