PD256 - IMPAIRED GASTROINTESTINAL FUNCTION IN CRITICALLY ILL PATIENTS: IMPACT ON FEEDING EFFICIENCY – PRELIMINARY DATA FROM THE ATTAINMENT STUDY

PD256

IMPAIRED GASTROINTESTINAL FUNCTION IN CRITICALLY ILL PATIENTS: IMPACT ON FEEDING EFFICIENCY – PRELIMINARY DATA FROM THE ATTAINMENT STUDY

C. Cobilinschi^1,2,*, A. C. Andrei^1,2, A. Dumitriu ^1,2, R. Darie^1,2, E. Moisă^2,3, V. Crișan^1,2, R. Ungureanu^1,2, I. Marandiuc⁴, R. Țincu^1,2, I. Grințescu^1,2, L. Mirea^1,2

¹Anaesthesiology and Intensive Care, Clinical Emergency Hospital of Bucharest, ²Anaesthesiology and Intensive Care, Carol Davila University of Medicine and Pharmacy, ³Anaesthesiology and Intensive Care, Elias Clinical Emergency Hospital, ⁴Cantacuzino National Institute for Medical Military Research and Development, Bucharest, Romania

Rationale: Although nutritional delivery is routinely quantified in critically ill patients, the actual metabolic availability of nutrients may differ substantially.Focusing only on prescribed or delivered nutrition may therefore overlook impaired gastrointestinal (GI) function.We aimed to identify patients with gastrointestinal dysfunction and evaluate whether adapting nutritional support can improve energy and protein delivery.

Methods: This randomized study included mechanically ventilated patients with controlled shock.GI dysfunction was assessed using gastric ultrasound and the paracetamol absorption test.Patients with GI dysfunction were randomized to receive either enteral nutrition (EN) alone or EN with supplemental parenteral nutrition (EN+SPN). Reassessment was performed on day 8 using both methods. Statistical analysis used non-parametric tests and Fisher’s exact test, as appropriate.

Results: A total of 126 patients met inclusion criteria and were assessed for GI dysfunction, of whom 44 (34.9%) had impaired GI function.No significant association was found with primary diagnosis, APACHE II or SOFA scores, or norepinephrine use.At day 4, antral cross-sectional area did not differ between groups (p = 0.619).At day 8, recovery was higher in the EN group (52.4% vs 38.9%), without statistical significance (p = 0.523; OR 0.57). Day 8 recovery rates did not differ by primary diagnosis(medical 46.2%, surgical 66.7%, trauma 37.5%;p = 0.54).

Conclusion: Impaired GI function can be identified in a substantial proportion of ICU patients using bedside tools. It was not associated with baseline severity or primary diagnosis, suggesting it is not easily predictable. Combining structural and functional assessment may improve detection, while tailored nutritional strategies may optimize nutrient delivery.

References: Clinicaltrials.gov: NCT06510348

Disclosure of Interest: None declared