Factors affecting the occurrence of adverse effects from the gastrointestinal tract during the implementation of enteral nutrition in ICU patients

Introduction: Enteral nutrition (EN) is feeding with industrial diets by artificial access to the gastrointestinal tract. During the implementation of this treatment some symptoms of intolerance from the gastrointestinal tract such as nausea, vomiting, diarrhea, residuals and constipation occur.

Aim: To analyze factors influencing intolerance of EN with industrial diets from the gastrointestinal tract in patients in the intensive care unit.

Material and methods: We retrospectively analyzed the medical and nursing documentation of 195 patients who were fed enterally for at least 5 days with industrial diets given by continuous infusion lasting 20 h a day. Side effects such as residuals and diarrhea, as well as the related need to discontinue nutritional therapy, were analyzed on the first, third and fifth days of EN.

Results: Enteral nutrition was implemented on average on the fourth day of the patient's stay in the intensive care unit (from 1 to 33 days). In 118 of the patients parenteral nutrition was implemented previously. Residuals were observed: on EN d1 in 49, on d3 in 37, and on d5 in 25 patients. Diarrhea was observed on d1 in 3, d3 in 10, and d5 in 7 patients.

Conclusions: Gradually implemented EN with industrial diets is well tolerated by patients of the intensive care unit. The main factor affecting the impaired tolerance of EN is worsening of the patient's general condition. The tolerance of EN is also affected by the speed of the supply of industrial diets.