Medicine (Baltimore). 2025 May 2;104(18):e42292. doi: 10.1097/MD.0000000000042292.
ABSTRACT
BACKGROUND: Early enteral nutrition (EEN) is the preferred nutritional strategy for critically ill patients in the intensive care unit (ICU). However, its implementation is often accompanied by various complications that can hinder the achievement of nutritional goals, thereby adversely impacting patient outcomes. To address these challenges, this study proposes an EEN protocol grounded in the principles of Enhanced Recovery After Surgery (ERAS), aiming to optimize nutritional support while minimizing enteral nutrition-related complications.
METHODS: A randomized controlled trial was conducted to develop an ERAS-based EEN protocol for intensive care patients. Using a quasi-experimental design and convenience sampling, 100 patients were randomized to either a control group receiving standard nutritional support or an intervention group receiving the ERAS-based protocol. Within 7 days of the intervention, outcomes – including calorie and protein intake, hemoglobin and albumin levels, gastrointestinal tolerance and ICU length of stay – were assessed and compared between groups.
RESULTS: After the intervention, the intervention group demonstrated significantly higher calorie intake [(1042.00 ± 232.58) kJ/d] and protein intake [(103.96 ± 13.52) g/d] than the control group [(876.30 ± 190.46) kJ/d and (97.00 ± 11.17) g/d] (P<.05). Initially, hemoglobin and albumin levels did not differ significantly between the 2 groups (P > .05). Post-intervention, the intervention group had higher hemoglobin [(117.16 ± 6.69) g/L] and albumin [(45.58 ± 3.23) g/L] levels compared to the control group [(106.98 ± 6.56) g/L and (41.78 ± 3.70) g/L] (P < .05). The intervention group had lower incidence rates of gastric retention (20.0%), diarrhea (12.0%), abdominal distension (14.0%), and gastrointestinal bleeding (6.0%) than the control group (38.0%, 22.0%, 32.0%, 12.0%). Gastric retention and abdominal distension incidence differences were statistically significant (P < .05). The intervention group’s ICU length of stay [(9.16 ± 3.48) d] was shorter than the control group’s [(11.86 ± 4.09) d] (P < .05).
CONCLUSION: The ERAS-based EEN protocol for ICU patients effectively improves nutritional status, improves gastrointestinal tolerance, reduces ICU length of stay, and contributes to better clinical outcomes in critically ill patients. These results provide a valuable reference for the implementation of EEN by ICU nurses.
PMID:40324272 | DOI:10.1097/MD.0000000000042292
