[Experience with early enteral nutrition application in critically ill patients in medical intensive care unit].

Background: Early enteral nutrition is recommended in patients with critical illness. Generally implementing of nutritional support algorithm is advised. The aim of study was evaluation of early enteral nutrition application in critically ill patients in medical intensive care unit.
Methods and Results: Early enteral nutrition was given according to written protocol in medical intensive care unit. During the first 96 hours hypocaloric nutrition 20-25 calories/kg was applied, followed by increase to 25-30 calories/kg at the end of the first week of admission. Apart from the patients who reached 25-30 calories/kg we recorded the number of patients who tolerated hypocaloric enteral nutrition and evaluated the number of patients with complications due to enteral nutrition. Early enteral nutrition was given to 44 out of 99 patients admitted to intensive care unit with life threatening diasese and indication for nutrition support. Out of 44 critically ill patients (35 with sepsis, 9 with another medical emergency) 22 died during admisssion in intensive care unit (50%). Hypocaloric enteral nutrition during the first 96 hours was given to 36 patients (82%). In 8 patients enteral nutrition had to be stopped and substituted for parenteral one due to complications. Three patients suffered from abdominal distension, 2 from profused diarrhea, 1 from combination of diarrhea and abdominal distension and 2 from aspiration. Twenty seven patients tolerated the application of enteral nutrition via nasogastric tube. In 10 patients nasogastric tube had to be replaced for nasojejunal one for high gastric aspirate volume. The caloric intake of 25-30 calories/kg was reached by the end of the first week of admission in 26 patients (60%).
Conclusions: Early enteral nutrition applied according to protocol was given succesfully to the substantial number of the critical patients. In 18% of the patients enteral nutrition had to be replaced for parenteral one due to complications. The caloric intake 25-30 calories/kg was reached in 60% of patients.