PD294 - ANALYSIS OF ENTERAL TUBE FEEDING PRACTICES AND THEIR ASSOCIATION WITH CLINICAL OUTCOMES IN MEDICAL INTENSIVE CARE UNIT PATIENTS

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PD294

ANALYSIS OF ENTERAL TUBE FEEDING PRACTICES AND THEIR ASSOCIATION WITH CLINICAL OUTCOMES IN MEDICAL INTENSIVE CARE UNIT PATIENTS

K.-W. Ryu1,*, J.-W. Baek1, B.-E. Kim1, E.-M. Kim1, C.-R. Chung2,3, C.-M. Park2,3

1Department of Dietetics, 2Department of Critical Care Medicine, Samsung Medical Center, 3Sungkyunkwan University School of Medicine, Seoul, Korea, Republic Of

 

Rationale: ESPEN guidelines recommend early and adequate delivery of enteral nutrition (EN) in critically ill patients. However, timely initiation and target achievement remain challenging in real-world clinical practice. We aimed to evaluate EN practices in a medical ICU and examine their association with clinical outcomes, including mortality and length of stay (LOS).

Methods: This single-center retrospective study (Jun 2024–Aug 2025) included medical ICU patients. Patients receiving exclusive continuous EN via tube feeding were compared with those receiving parenteral nutrition (PN); EN+PN, oral intake, and others were included in descriptive analyses. Early EN was defined as initiation within 48 h. Time to reach 80% and 100% of target feeding rate was assessed in patients with EN ≥5 d. Data were analyzed using Mann–Whitney U, chi-square, log-rank test, and Cox regression adjusted for age and sex.

Results: A total of 442 patients were analyzed (EN n=210, PN n=140, EN+PN, oral intake, or others n=92). Mean age was 61.4±14.8 y (63.8% male). EN was initiated at a median of 23.8 h (IQR 16.7–39.8); 85.9% achieved early EN. Time to reach 80% and 100% of target feeding rate was 3.8±1.7 and 4.5±1.9 d, respectively. ICU LOS did not differ significantly between EN and PN groups. PN was associated with higher ICU mortality (25.0% vs 16.7%; aHR 1.68, 95% CI 1.05–2.69, p=0.032) and 90-day mortality (55.2% vs 32.7%; aHR 1.98, 95% CI 1.42–2.77, p<0.001).

Conclusion: EN initiation and time to reach target feeding rate were consistent with current guideline recommendations. EN was independently associated with reduced ICU and 90-day mortality compared with PN, highlighting the potential clinical importance of nutrition route selection in critically ill patients. These findings support the clinical value of protocol-driven EN delivery and warrant confirmation in prospective multicenter studies.

Disclosure of Interest: None declared