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ICU Patients are at High Risk for Complications

Did you know…?

Trauma and surgical intensive care unit (TSICU) patients supported with mechanical ventilation are at high risk for complications associated with malnutrition.[1]

Despite these interventions, TSICU patients often suffer a calorie deficit associated with enteral nutrition interruption for procedures or transitions in care.[1]

References:

  1. Shahmanyan, D., Lawrence, J.C., Lollar, D.I., Hamill, M.E., Faulks, E.R., Collier, B.R., Chestovich, P.J. and Bower, K.L. (2021), Early feeding after percutaneous endoscopic gastrostomy tube placement in trauma and surgical intensive care patients: A retrospective cohort study. Journal of Parenteral and Enteral Nutrition. (First published: November 17, 2021). https://doi.org/10.1002/jpen.2303

ICU Nutritional Practice-Tuesday Tube Facts

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For enteral Covid-19 patients, feeding tube placement and aspiration are potential aerosol generating procedures.[1]

Tip to decrease Covid-19 exposure due to aerosol generating procedures: Decrease exposure by quicker gastric tube placement rather than postpyloric placement.[3]

References:

  1. Rimensberger, Peter C., et al. “Caring for Critically Ill Children with Suspected or Proven Coronavirus Disease 2019 Infection: Recommendations by the Scientific Sections’ Collaborative of the European Society of Pediatric and Neonatal Intensive Care.” Pediatric Critical Care Medicine, vol. 22, no. 1, 2020, pp. 56–67., doi:10.1097/pcc.0000000000002599.

Covid19 prone EN-Tuesday Tube Facts

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For COVID-19 ICU patients in the prone position, enteral nutrition in the stomach is generally well-tolerated.[1]

On occasion, postpyloric placement of the feeding tube may be indicated. Placement of postpyloric tubes increases exposure to SARS‐CoV‐2, and thus their use should be considered only on a case‐by‐case basis in patients with COVID‐19.[1]

References:

  1. Patel, J.J., Martindale, R.G. and McClave, S.A. (2020), Relevant Nutrition Therapy in COVID‐19 and the Constraints on Its Delivery by a Unique Disease Process. Nutrition in Clinical Practice, 35: 792-799. doi:10.1002/ncp.10566.

COVID EN Tube Type-Tuesday Tube Facts

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Small-diameter feeding tubes (10-12 French) are recommended for COVID-19 patients in the ICU who require enteral nutrition.[1]

References:

  1. Martindale, R., Patel, J., Taylor, B., Warren, M., McClave, S. Nutrition Therapy in the Patient with COVID-19 Disease Requiring ICU Care. Reviewed and Approved by the Society of Critical Care Medicine and the American Society for Parenteral and Enteral Nutrition. May 27, 2020. https://doi.org/10.1002/jpen.1930

ICU LOS Increase with EN Interruption-Tuesday Tube Facts

Did you know…?

For critically ill surgical patients, interruptions to EN increases length of ICU stay by 1.5 days.

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References:

  1. Peev, M. P., Yeh, D. D., Quraishi, S. A., Osler, P. , Chang, Y. , Gillis, E. , Albano, C. E., Darak, S. and Velmahos, G. C. Causes and Consequences of Interrupted Enteral Nutrition. Journal of Parenteral and Enteral Nutrition. 2015. 39: 21-27.