Format

Send to

Choose Destination
Anaesth Intensive Care. 2016 Jan;44(1):93-8.

Enhanced Protein-Energy Provision via the Enteral Route Feeding (PEPuP) protocol in critically ill surgical patients: a multicentre prospective evaluation.

Author information

1
Royal Adelaide Hospital, North Terrace, Adelaide, South Australia.
2
Royal Adelaide Hospital and Discipline of Acute Care Medicine, University of Adelaide, Adelaide, South Australia.
3
Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, Ontario, Canada.
4
Intensive Care Unit, Royal Adelaide Hospital, and Discipline of Acute Care Medicine, North Terrace, Adelaide, South Australia.

Abstract

Suboptimal levels of feeding in critically ill patients are associated with poor clinical outcomes. The Enhanced Protein-Energy Provision via the Enteral Route Feeding (PEPuP) protocol was developed to improve nutritional delivery in the critically ill and has been studied in several hospitals. However, the experience with this protocol in surgical patients is limited to date. The objective of this analysis was to describe the experience with this protocol in surgical patients. We analysed observational patient data obtained from the 2013 International Nutrition Survey. We compared nutritional practices and outcomes of patients admitted for surgical and medical reasons to ICUs in sites that implemented the PEPuP protocol. We used surgical ICU patients in non-PEPuP sites as a concurrent control group. In sites that implemented the PEPuP protocol, surgical patients received a smaller proportion of prescribed calories (43% versus 61%, P=0.004) and protein (38% versus 57%, P=0.002) compared to medical patients. When compared to the cohort of surgical patients from control sites, the surgical patients from PEPuP sites received similar amounts of calories and protein. Although surgical PEPuP patients were more likely to receive trophic and volume-based feeds compared to surgical patients in control sites, other aspects of the PEPuP protocol were not adequately implemented. We conclude that nutritional delivery to surgical patients remains inadequate and the PEPuP protocol seems ineffective in improving nutritional intake in this population. Further research to determine methods of optimising PEPuP protocol implementation and adherence in surgery patients is needed.

KEYWORDS:

clinical care; feeding protocols; nutritional therapy

PMID:
26673594
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Australian Society of Anaesthetists
Loading ...
Support Center