PD234 - ENTERAL NUTRITION ADMINISTRATION PRACTICES IN THE INTENSIVE CARE UNIT: AN INTERNATIONAL SURVEY IN HEALTHCARE WORKERS

PD234

ENTERAL NUTRITION ADMINISTRATION PRACTICES IN THE INTENSIVE CARE UNIT: AN INTERNATIONAL SURVEY IN HEALTHCARE WORKERS

S. W. Van Beek^1,2,*, L.-A. S. Chapple^3,4, D. E. Bear^5,6, A. R. H. van Zanten^1,2, I. W. K. Kouw^1,2

¹Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, ²Department of Intensive Care Medicine & Research, Gelderse Vallei Hospital, Ede, Netherlands, ³Intensive Care Unit, Royal Adelaide Hospital, ⁴School of Medicine, Adelaide University, ⁵Department of Nutrition and Dietetics, Royal Adelaide Hospital, ⁶Department of Nutritional Sciences, King’s College London, Adelaide, Australia

Rationale: International recommendations for administration methods of enteral nutrition (EN) in critically ill patients are limited. Continuous EN is most applied in preference to bolus, intermittent, or cyclic feeding, yet the rationale used to guide the administration method remains unclear. This survey evaluated current nutrition practices, challenges, and perceptions of EN administration methods among ICU clinicians.

Methods: A cross-sectional digital survey with 21 questions was distributed internationally to adult ICU clinicians, assessing the reasons, facilitators, and barriers for different EN administration methods. Data were summarized using descriptive analyses.

Results: A total of 852 responses were received, with 706 responses eligible for analysis. At EN initiation, continuous feeding was applied most (n=584/82.7%), while intermittent/bolus and cyclic feeding was applied in n=88/12.5% and: n=34/4.8%, respectively. Non-continuous EN was mostly considered in the late phase (>day 7; n=526/74.3%), compared with the early (day 1-2; n=129/18.2%) and late acute phase (day 3-7; n=167/23.6%). Facilitators of intermittent, bolus, or cyclic EN included transitioning to oral intake and increased mobility; barriers were the risk of gastrointestinal intolerance and change of standard practise. Professionals using non-continuous feeding at any timepoint (~44%) were less likely to increase safety parameter monitoring compared to those not using non-continuous EN (~9%).

Conclusion: Intermittent, bolus, and cyclic EN is infrequently administered in ICUs globally. Perceived barriers including gastrointestinal intolerance appear more pronounced among professionals currently not using non-continuous feeding. Future trials should address existing challenges on safety and efficacy of non-continuous feeding methods to support evidence-based practises in critical care.

Disclosure of Interest: S. Van Beek: None declared, L.-A. Chapple Grant / Research Support from: Nutricia Australia, D. Bear Consultant for: Baxter Healthcare, Speakers Bureau of: Baxter Healthcare, A. van Zanten Grant / Research Support from: Abbott, AOP Pharma, Baxter, Cardinal Health, Nutricia-Danone, Dutch Medical Food, Fresenius Kabi, GE Healthcare, Nestle Healthcare, PAION, and Rousselot, Speakers Bureau of: Abbott, AOP Pharma, Baxter, Cardinal Health, Nutricia-Danone, Dutch Medical Food, Fresenius Kabi, GE Healthcare, Nestle Healthcare, PAION, and Rousselot, I. Kouw Grant / Research Support from: NWO/ZonMW Veni Fellowship