Effects of Nutritional Interventions based on Enteral Nutrition Guidelines for Neurosurgical Intensive Care Unit Patients

Han, Jung-Hee; Kim, Young Ran; Lee, Young Min; Kim, Ae Lee; Kim, Ho Jin; Jeong, Young-Gyun; Ryu, Jeong Ha

Journal of Korean Society Quality Assurance Health Care 2011;17(1): 79.
Published online December 30, 2011.

신경외과 중환자실 환자의 경장영양 지침서 적용에 따른 영양적 중재 효과

한정희¹, 김영란¹, 이영민¹, 김애리², 김호진², 정영균³, 유정하⁴

¹인제대학교부산백병원 영양과
²인제대학교부산백병원 간호부
³인제대학교부산백병원 신경외과
⁴인제대학교부산백병원 QI실

Effects of Nutritional Interventions based on Enteral Nutrition Guidelines for Neurosurgical Intensive Care Unit Patients

Jung-Hee Han¹, Young Ran Kim¹, Young Min Lee¹, Ae Lee Kim², Ho Jin Kim², Young-Gyun Jeong³, Jeong Ha Ryu⁴

¹Department of Nutrition, Busan Paik Hospital, Inje University
²Department of Nursing, Busan Paik Hospital, Inje University
³Department of Neurosurgery, Busan Paik Hospital, College of Medicine, Inje University
⁴Department of QI, Busan Paik Hospital, Inje University

Abstract

Background
Evidence-based guidelines are now used for enteral nutrition(EN) in neurosurgical intensive care unit patients who mostly depend on EN. This study compared and analyzed the nutritive conditions of patients before and after they underwent guideline based nutritional interventions in order to determine whether using these guidelines improved their calorie supply.
Methods
Data on the patients' nutritional requirements, maximum calorie supply through EN, serum albumin level, and total lymphocyte count were collected and analyzed using SAS version 9.1.3. All the statistical analyses were performed at a significance level of P<0.05.
Result
The maximum calorie supply through EN was $923.1{pm}359.7$ kcal before the intervention and $1254.4{pm}196.3$ kcal after the intervention; this difference was statistically significant(P<0.05). The ratio of nutritional requirements to maximum calorie supply through EN was $55.5{pm}22.4%$ and $74.2{pm}13.9%$ before and after the intervention, respectively; this difference was statistically significant(P<0.05). This indicates a 19% increase in the ratio after the nutritional intervention. The serum albumin level also significantly increased from $2.7{pm}0.6g/dL$ before the intervention to $3.2{pm}0.4g/dL$ after the intervention(P<0.05). The total lymphocyte count slightly increased from $1267.7{pm}728.2cells/mm^3$ before the intervention to $1801.9{pm}1211.5cells/mm^3$ after the intervention; this difference was not statistically significant.
Conclusion
The results showed that using the evidence-based feeding guidelines for interventions increased the calorie supply and improved the patients' nutritive conditions from moderate malnutrition to mild malnutrition.

Key words Enteral nutrition;Critically ill patients;Malnutrition;