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Quasi‐experimental feeding study in patients admitted for elective gastrointestinal surgery at Bach Mai Hospital (BMH), Hanoi, Vietnam
Author(s) -
Huong PTT,
Lam NT,
Thu NT,
Anh NQ,
Hoc TH,
Lien DTK,
Gura Kathleen,
Ziegler Thomas R.,
Plourde Kendra,
Young Lorraine S.
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.669.1
Subject(s) - medicine , calorie , perioperative , body mass index , anthropometry , referral , parenteral nutrition , body weight , pediatrics , surgery , nursing
Objective To determine the feasibility of a multidisciplinary comprehensive feeding intervention to improve the perioperative intake of calories and proteins in patients admitted for elective gastro‐intestinal surgery in a referral hospital. Secondary outcomes examined included feeding route and anthropometrics. Methods This is a three‐month quasi‐experimental study of consecutive patients admitted for GI surgery receiving standard hospital nutrition care (n= 46) in 2013 vs. a comprehensive feeding protocol (n=62) in 2014 ( Fig. 1). ASPEN nutrition guidelines were used. Data included age, sex, mid‐upper‐arm circumference, weight, height, dietary intake, feeding route, length of stay, and post‐op complications. Calories and protein intake were calculated using a Vietnam Food Analysis software developed by the National Institute of Nutrition (NIN), Vietnam. Body Mass Index (BMI) was calculated in kg/m 2 and classified using WHO references. Descriptive analysis and Wilcoxon rank sum tests were used. Results Participants in the standard group were 55.5±14.8 y, 52% female, had a BMI of 18.8±2.7 kg/m 2 , and length of stay (LOS) was 12.6±5.6 days. Their pre‐op weight, height, and BMI were similar but they differed by MUAC (23.2±3.0 vs. 25.0±2.4 mm, p<0.0001). The intervention group received 30±6 kcals/kg and 1.37±0.27 g protein/kg vs. 15±6 kcals/kg and 0.61±0.26g protein/kg), p<0.0001 in the standard group. Parenteral nutrition was discontinued on day 5 in 61(100%) patients in the intervention vs. 28(65%) in the standard group (P<0.0001). Although there was no significant change in weight and MUAC during the hospitalization, more subjects lost greater than 10 % weight (n=4/46, 91%) in the intervention vs. the standard group (n=62 (100%), p=0.031). No adverse events were identified. Conclusions The implementation of an evidence‐based nutrition support feeding protocol is feasible in Vietnam. This study illustrates the impact a multifaceted approach including service, education, and research can have on improving hospital based clinical nutrition in Vietnam. Support or Funding Information This study was performed with the Abbott Fund Institute of Nutrition Science: a partnership between Boston University School of Medicine, BMH, the National Institute of Nutrition, Hanoi Medical University, and the Abbott Fund, the philanthropic foundation of Abbott, to advance nutrition care in Vietnam hospitals.