Nutrition practices in Australia and New Zealand in response to evolving evidence: Results of three point-prevalence audits.

Calorie dose Calorie prescription Critical care Enteral nutrition Practice change

Journal

Australian critical care : official journal of the Confederation of Australian Critical Care Nurses
ISSN: 1036-7314
Titre abrégé: Aust Crit Care
Pays: Australia
ID NLM: 9207852

Informations de publication

Date de publication:
22 Aug 2024
Historique:
received: 22 04 2024
revised: 05 07 2024
accepted: 21 07 2024
medline: 24 8 2024
pubmed: 24 8 2024
entrez: 23 8 2024
Statut: aheadofprint

Résumé

The Augmented versus Routine Approach to Giving Energy Trial (TARGET) was a 4000-patient trial in which augmented enteral calorie dose did not influence outcomes. We aimed to quantify practice change following TARGET. Three single-day, prospective, multicentre, point-prevalence audits of adult patients receiving enteral nutrition (EN) in participating Australian and New Zealand intensive care units at 10:00 AM were conducted: (i) 2010 (before conducting TARGET); (ii) 2018 (immediately before publishing TARGET results); and (iii) 2020 (2 years after TARGET publication). Data included baseline characteristics, clinical outcomes, and nutrition data. Data are n (%), mean ± standard deviation, or median [interquartile range]. Differences in enteral calorie prescription between 2018 and 2020 were compared using the Mann-Whitney test. The percentage of patients receiving EN (2010 42%, 2018 38%, 2020 33%; P = 0.012) and the prescription of calorie-dense EN formula (≥1.5 kcal/ml) (2010 33%, 2018 24%, 2020 23%; P = 0.038) decreased over time. However, when comparing prepublication and postpublication (2018-2020), calorie dose and calorie density were similar: 22.9 ± 8.6 versus 23.4 ± 12.8 kcal/kg/day (P = 0.816) and <1.5 kcal/ml: 76 versus 77% (P = 0.650), respectively. In Australian and New Zealand intensive care units, enteral calorie dose and calorie density of prescribed EN were similar before TARGET publication and 2 years later.

Sections du résumé

BACKGROUND BACKGROUND
The Augmented versus Routine Approach to Giving Energy Trial (TARGET) was a 4000-patient trial in which augmented enteral calorie dose did not influence outcomes.
AIM OBJECTIVE
We aimed to quantify practice change following TARGET.
METHODS METHODS
Three single-day, prospective, multicentre, point-prevalence audits of adult patients receiving enteral nutrition (EN) in participating Australian and New Zealand intensive care units at 10:00 AM were conducted: (i) 2010 (before conducting TARGET); (ii) 2018 (immediately before publishing TARGET results); and (iii) 2020 (2 years after TARGET publication). Data included baseline characteristics, clinical outcomes, and nutrition data. Data are n (%), mean ± standard deviation, or median [interquartile range]. Differences in enteral calorie prescription between 2018 and 2020 were compared using the Mann-Whitney test.
RESULTS RESULTS
The percentage of patients receiving EN (2010 42%, 2018 38%, 2020 33%; P = 0.012) and the prescription of calorie-dense EN formula (≥1.5 kcal/ml) (2010 33%, 2018 24%, 2020 23%; P = 0.038) decreased over time. However, when comparing prepublication and postpublication (2018-2020), calorie dose and calorie density were similar: 22.9 ± 8.6 versus 23.4 ± 12.8 kcal/kg/day (P = 0.816) and <1.5 kcal/ml: 76 versus 77% (P = 0.650), respectively.
CONCLUSION CONCLUSIONS
In Australian and New Zealand intensive care units, enteral calorie dose and calorie density of prescribed EN were similar before TARGET publication and 2 years later.

Identifiants

DOI: 10.1016/j.aucc.2024.07.079 PMID: 39179491
pubmed: 39179491
pii: S1036-7314(24)00208-X
doi: 10.1016/j.aucc.2024.07.079
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Australian College of Critical Care Nurses Ltd. All rights reserved.

Auteurs

L S Chapple (LS)

Intensive Care Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia; Adelaide Medical School, The University of Adelaide, South Australia, Australia; Centre of Research Excellence in Nutritional Physiology, The University of Adelaide, South Australia, Australia; Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. Electronic address: lee-anne.chapple@adelaide.edu.au.

A Neuts (A)

Intensive Care Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia; Department of Anesthesiology and Intensive Care Medicine, Jessa Hospital, Hasselt, Belgium.

S N O'Connor (SN)

Intensive Care Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia; Adelaide Medical School, The University of Adelaide, South Australia, Australia; Centre of Research Excellence in Nutritional Physiology, The University of Adelaide, South Australia, Australia.

P Williams (P)

Adelaide Medical School, The University of Adelaide, South Australia, Australia; Centre of Research Excellence in Nutritional Physiology, The University of Adelaide, South Australia, Australia; Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Intensive Care Unit, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.

S Hurford (S)

Medical Research Institute of New Zealand, Wellington, New Zealand.

P J Young (PJ)

Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Medical Research Institute of New Zealand, Wellington, New Zealand; Intensive Care Unit, Wellington Hospital, Wellington, New Zealand; Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia.

N E Hammond (NE)

Critical Care Program, The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Newtown, NSW, Australia; Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Sydney, Australia.

S Knowles (S)

Critical Care Program, The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Newtown, NSW, Australia.

M J Chapman (MJ)

Intensive Care Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia; Adelaide Medical School, The University of Adelaide, South Australia, Australia; Centre of Research Excellence in Nutritional Physiology, The University of Adelaide, South Australia, Australia; Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

S Peake (S)

Adelaide Medical School, The University of Adelaide, South Australia, Australia; Centre of Research Excellence in Nutritional Physiology, The University of Adelaide, South Australia, Australia; Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Intensive Care Unit, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.

Classifications MeSH