Premium
Incidence and Effects of Feeding Intolerance in Trauma Patients
Author(s) -
Virani Farrukh R.,
Peery Travis,
Rivas Orlyn,
Tomasek Jeffrey,
Huerta Ravin,
Wade Charles E.,
Lee Jenny,
Holcomb John B.,
Uray Karen
Publication year - 2019
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.1469
Subject(s) - medicine , incidence (geometry) , sepsis , complication , intensive care unit , parenteral nutrition , retrospective cohort study , systemic inflammatory response syndrome , enteral administration , gastroenterology , physics , optics
Background Although feeding intolerance is a common complication in trauma patients, the incidence, development, and effects are poorly understood. Methods We performed a retrospective study in which trauma patients were classified as having feeding intolerance based on time to reach feeding goal. Subsequently, we sorted patients by gastric residual volumes (GRVs) or symptoms of slowed gastrointestinal motility. Results One‐third of trauma patients experienced delayed time to reach feeding goal after diet initiation. Delayed feeding was associated with prolonged intensive care unit (ICU) stays, increased readmission rates, and increased incidence of sepsis. Patients with elevated GRV (>500 mL) had significantly prolonged ICU and hospital stays and increase incidence of sepsis. Patients with >2 symptoms of slowed gastrointestinal motility had prolonged ICU and hospital stays, delayed time to reach feeding goals, significantly increased readmission rates, increased incidence of infectious and thromboembolic complications and sepsis, decreased serum prealbumin levels, and increased CRP levels. Conclusion Decreased gastrointestinal motility in trauma patients is associated with worse outcomes and increased systemic inflammation.