Fatores determinantes na inadequação entre prescrição e recebimento de terapia nutricional enteral em pacientes hospitalizado / Factors leading to discrepancies between prescription and intake of enteral nutrition therapy in hospitalized patients
AUTOR(ES)
Juliana Renofio Martins
FONTE
IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia
DATA DE PUBLICAÇÃO
25/05/2012
RESUMO
We investigated factors leading to a reduction in enteral nutrition (EN) prescribed by a nutritional support team (NST) at a general hospital in Brazil. In this prospective, observational study, hospitalized adults receiving only EN therapy via tube feeding were followed for up to 21 days between July and October 2008. The 152 subjects analyzed included 36 (23.5%) ward patients and 116 (76.5%) intensive care unit (ICU) patients. Eighty percent of the targeted feeding volume was achieved on day 4 by 80% of the patients. Inadequacy between prescription and intake of EN was 20%. Reasons for not receiving the total amount of EN prescribed included delay in the EN administration (3.1%), abdominal distention (5.6%), patient refusal to treatment (6.8%), feeding tube obstruction (8.6%), vomiting (10.5%), diarrhea (17.9%), unknown causes (17.9%), interference by a non-NST physician (25.9%), accidental feeding tube loss (34%), presence of high gastric residual (34%), and operational logistics at the hospitals Nutrition and Dietetics Service (99.4%). There was a significant association between patients who received less than 60% of the prescribed EN and external physician interference (p=0.016). Patients in ICU also received inadequate EN (p=0.025). Neurologic patients had a greater chance of receiving more than 80% of the prescribed EN amount than cardiac patients (Odds Ratio=3.75, p<0.01). Cardiologic patients and ICU patients are at a higher risk of inadequacy between prescription and intake of EN
ASSUNTO(S)
intensive care unit nutrição enteral nutritional therapy enteral nutrition inadequate prescription prescrição inadequada prescrições prescriptions terapia nutricional unidade de terapia intensiva
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