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EP.008
Nasogastric feed and propofol use in the nutrition of critically unwell patients: an acute trust experience

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Nasogastric feed and propofol use in the nutrition of critically unwell patients: an acute trust experience Sean C Menezes 1 , Brigid Sharkey 2 , and Shibaji Saha 2 Department of Anesthetics and Critical Care, 1Colchester Hospital University NHS Foundation Trust and 2Barking, Havering, and Redbridge University Hospitals NHS Trust

Introduction

• Nutrition is an essential part of the management of critically unwell patients • Early feeding has a positive impact on patient outcomes by improving: • Nitrogen balance • Wound healing and host immune function • Metabolic response to tissue injury • Intestinal mucosal integrity • However, there remains a delay in initiating enteral feeding in most critical care units (CCU) • Additionally, the use of lipid-rich propofol as a sedative provides a source of high-fat calories, potentially worsening suboptimal nutrition

Aims and objectives

• To determine the proportion of the daily calculated recommended energy intake (cREI) provided in the acute period by our nasogastric (NG) feeds and propofol use • To examine the role that propofol played in contributing to the cREI • To determine the proportion of the daily calculated recommended protein intake (cRPI) provided by the NG feeds

Methods

• Patients were identified that were intubated and ventilated and were sedated with propofol • Only those with no contra-indication to NG feeds were included • Analysis of drug card, notes, and CCU monitoring chart • cREI and cRPI were determined by the CCU dietitian and were calculated by using: • their pre-admission nutritional status • Ideal body weight • Targets of 25-35 kcal/kg/day and 0.625-1.875 g of protein/kg/day • Notes were examined for seven days of admission to reflect the acute period over 14 random days

 

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