Year: 2013
Type: article
Abstract: I appreciated the recent interesting paper on factors influencing outcome in intensive care unit (ICU) cardiac arrest patients by Lee et al.1 This paper reports that receiving enteral nutrition within 24 h of cardiac arrest was associated with a significantly higher 3-month survival [odds ratio (OR) = 9.943, 95% confidence interval (CI) 1.961–50.426].1 Prompt enteral feeding may significantly reduce both morbidity and mortality in cardiac arrest patients and patients with many other acute illnesses. A meta-analysis of randomised enteral nutrition trials on ICU patients reported that providing enteral nutrition within 24 h of severe injury and/or ICU admission was associated with significantly lower mortality (OR = 0.34, 95% CI 0.14–0.85; six trials with 234 patients) and significantly lower pneumonia rates (OR = 0.31, 95% CI 0.12–0.78; two trials with 80 patients) as compared with patients who did not receive enteral nutrition within 24 h.2 A meta-analysis of 16 published studies of head trauma patients reported that early enteral feeding (before 12–72 h after injury) was associated with significantly lower mortality [relative risk (RR) 0.35; 95% CI 0.24–0.50; seven studies with 1364 total patients] and significantly lower infection rates (RR = 0.77, 95% CI 0.59–0.99; four studies with 169 total patients) compared with patients without early enteral nutrition.3 A study of 138 patients with 10–80% skin surface burns reported significantly lower pneumonia rates (38% vs. 15%, P = 0.04) in patients receiving adequate enteral nutrition (30–40 cal/kg/day) as compared with burn patients who did not receive enteral nutrition.4 A study of acute pancreatitis patients reported that 97 patients who received enteral nutrition within 48 h of admission had significantly lower rates of infected necrosis/fluid collection (4.4% vs. 18.0%, P = 0.002), respiratory failure (5.2% vs. 15.0%, P = 0.022) and mortality (0.0% vs. 9.0%, P = 0.007) as compared with 100 acute pancreatitis patients who did not receive enteral nutrition in the first 48 h.5 Prompt and adequate enteral nutrition is vital to reduce mortality and morbidity in many types of acutely ill patients. Much more clinical and research attention is needed on the nutritional needs of patients with heart attacks and other serious conditions. Conflict of interest: None.
DOI: 10.1111/aas.12162
Author: L. CURTIS
Language: English
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W1981124898