Nutrition delivery during hospitalisation after critical illness in Australia and New Zealand: a multicentre, prospective observational study.

Author(s)
Ridley, Emma J
Ainscough, Kate
Bailey, Michael
Baskett, Rebecca
Bone, Allison
Campbell, Lewis
Capel, Eleanor
Chapple, Lee-Anne
Cheng, Andrew
Deane, Adam M
Doola, Ra'eesa
Ferrie, Suzie
Fetterplace, Kate
Gilder, Eileen
Higgins, Alisa M
Hodgson, Carol L
King, Victoria
Marshall, Andrea P
Nichol, Alistair
Peake, Sandra
Ramanan, Mahesh
Neto, Ary Serpa
Udy, Andrew
Williams, Patricia
Winderlich, Jacinta
Young, Paul J
Publication Date
2025-02-01
Abstract
Energy and protein provision for critically ill patients who receive oral nutrition often falls below recommended targets. We compared characteristics and nutrition processes during hospital stay (within and post-intensive care unit [ICU] stay) of those who received oral nutrition as the sole nutrition source to those who first commenced enteral (EN) or parenteral nutrition (PN) within an Australian or New Zealand (ANZ) ICU.Multicentre, observational study of routine nutrition care in 44 hospitals across ANZ, including adult patients within ICU admitted for at least 48 h. Those receiving oral nutrition as the sole source of nutrition (with or without oral nutrition supplements) were included in the 'oral nutrition' group and those who first received EN and/or PN in the ICU as the 'EN/PN group'. The primary outcome was median daily energy delivery in ICU. Data are presented as number (%) or median [interquartile range].Of the 409 patients enroled, median [IQR] age was 64 [51-74] years and 257 patients (62%) were male. APACHE II score, use of invasive ventilation and hospital length of stay (LOS) were all lower in those receiving oral nutrition (n = 200) compared to those receiving EN/PN (n = 209). In ICU, 63 (31.5%) and 169 (81%) (p < 0.001), patients who were receiving oral nutrition and in the EN/PN group received a nutrition assessment, respectively. Oral nutrition supplements were provided for 40 (20%) patients in the oral nutrition group and 31 of 94 (33%) of those receiving oral nutrition in the EN/PN group (p = 0.019). Energy and protein intake in ICU for the oral nutrition group was 716 [597-1069] kcal/day and 37 [19-46] g/day versus 1158 [664-1583] kcal/day and 57 [31-77] g/day for those receiving EN/PN (p = 0.020 energy, p = 0.016 protein). Quantification of oral nutrition was attempted in 78/294 (27%) patients in ICU and completed on 27/78 (36%) occasions. On the ward, attempts were made for 120/273 (44%) patients, with 60/120 (50%) complete.Patients who received oral nutrition as the sole nutrition source in ICU had lower illness severity, rates of nutrition assessment and provision of oral supplements compared to those who first received EN/PN. Quantification of oral nutrition was often incomplete for all patients in ICU and on the ward.
Affiliation
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
Dietetics and Nutrition, The Alfred, Melbourne, Victoria, Australia.
Clinical Research Centre, University College Dublin Clinical Research Centre at St. Vincent's University Hospital, Dublin, Ireland.
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
Cardiovascular Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand.
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
Intensive Care Unit, University Hospital Geelong, Geelong, Australia.
Intensive Care Unit, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
Menzies School of Health Research, Darwin, Northern Territory, Australia.
Dietetics Department, Northeast Health Wangaratta, Wangaratta, Australia.
Intensive Care Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Department of Intensive Care, The St George Hospital, Kogarah, New South Wales, Australia.
Intensive Care Unit, Shoalhaven District Memorial Hospital, Nowra, New South Wales, Australia.
Intensive Care Unit, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia.
Functioning and Health Research, Metro South Health, Brisbane, Queensland, Australia.
Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
PA-Southside Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
Department of Nutrition and Dietetics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
School of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia.
Department of Allied Health (Clinical Nutrition), The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Cardiovascular Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand.
School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
Critical Care Division, The George Institute for Global Health, Sydney, New South Wales, Australia.
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
Critical Care Division, The George Institute for Global Health, Sydney, New South Wales, Australia.
Physiotherapy Department, The Alfred, Melbourne, Victoria, Australia.
Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia.
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
Intensive Care Unit, Gold Coast University Hospital, Southport, Queensland, Australia.
School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia.
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
Clinical Research Centre, University College Dublin Clinical Research Centre at St. Vincent's University Hospital, Dublin, Ireland.
Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Department of Intensive Care Medicine, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.
Critical Care Division, The George Institute for Global Health, Sydney, New South Wales, Australia.
Caboolture and the Prince Charles Hospitals, Metro North Hospital and Health Services, Brisbane, Queensland, Australia.
James Mayne Academy of Critical Care, The University of Queensland, St Lucia, Queensland, Australia.
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
Department of Intensive Care, Austin Hospital, Melbourne, Australia.
Department of Critical Care, Melbourne Medical School, University of Melbourne, Austin Hospital, Melbourne, Australia.
Department of Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Department of Intensive Care Medicine, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
Nutrition and Dietetics, Monash Children's Hospital, Melbourne, Victoria, Australia.
Paediatric Intensive Care Unit, Monash Children's Hospital, Melbourne, VIC, Australia.
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia.
Intensive Care Unit, Wellington Hospital, Wellington, New Zealand.
Medical Research Institute of New Zealand, Wellington, New Zealand.
Citation
J Hum Nutr Diet . 2025 Feb;38(1):e13385. doi: 10.1111/jhn.13385.
ISSN
1365-277X
OrcId
0000-0002-7922-5717
0000-0002-1094-1619
0000-0001-7692-403X
0000-0002-5176-7450
Pubmed ID
https://pubmed.ncbi.nlm.nih.gov/39587763/?otool=iaurydwlib
Link
Subject
critical illness
enteral nutrition
nutrition practice
oral nutrition
parenteral nutrition
MESH subject
Humans
New Zealand
Male
Female
Critical Illness
Australia
Middle Aged
Aged
Prospective Studies
Parenteral Nutrition
Enteral Nutrition
Intensive Care Units
Length of Stay
Hospitalization
Energy Intake
APACHE
Dietary Proteins
Critical Care
Nutritional Status
Title
Nutrition delivery during hospitalisation after critical illness in Australia and New Zealand: a multicentre, prospective observational study.
Type of document
Journal Article
Entity Type
Publication

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