Risk Factors of Enternal Nutrition Intolerance in Septic Patients: A Case-control Study

Li-zhu Wang1(), Yan Xiang1, Qian Li1, Yi-rong Zhu1, Jue Fang1, Xiao-dan Lu1, Zhao-cai Zhang2,3,4()

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Current Medical Science ›› 2024, Vol. 44 ›› Issue (2) : 328-332. DOI: 10.1007/s11596-024-2849-3

Risk Factors of Enternal Nutrition Intolerance in Septic Patients: A Case-control Study

  • Li-zhu Wang1(), Yan Xiang1, Qian Li1, Yi-rong Zhu1, Jue Fang1, Xiao-dan Lu1, Zhao-cai Zhang2,3,4()
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Abstract

Abstract
Objective

This study aimed to investigate the incidence of enteral nutrition intolerance (ENI) in patients with sepsis and explore potential risk factors.

Methods

A case-control study was conducted in patients with sepsis who were receiving enteral nutrition (EN) at a tertiary hospital in China. The included patients were divided into the ENI group and the non-ENI group. Univariate and multivariate analyses were performed to identify the risk factors for ENI.

Results

A total of 859 patients were included in the study. Among them, 288 (33.53%) patients experienced symptoms of ENI, including diarrhea, vomiting, bloating, and gastric retention. Logistic regression analysis revealed that the Acute Physiology and Chronic Health Evaluation H (APACHE H) score, thoracocentesis, and usage of cardiotonic drugs (namely, inotropes) were independent predictors of the ENI.

Conclusion

The incidence of ENI is relatively high in patients with sepsis, especially in those who have higher APACHE H scores, have undergone thoracocentesis, and have received inotropes.

Keywords

sepsis / enteral nutrition intolerance / influencing factor

Cite this article

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Li-zhu Wang, Yan Xiang, Qian Li, Yi-rong Zhu, Jue Fang, Xiao-dan Lu, Zhao-cai Zhang. Risk Factors of Enternal Nutrition Intolerance in Septic Patients: A Case-control Study. Current Medical Science, 2024, 44(2): 328‒332 https://doi.org/10.1007/s11596-024-2849-3

References

[1]
Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (sepsis 3). Jama, 2016,315(8):775–787
[2]
Fleischmann-Struzek C, Mellhammar L, Rose N, et al. Incidence and mortality of hospital-and ICU-treated sepsis: results from an updated and expanded systematic. review and meta-analysis. Intensive Care Med, 2020,46(8):1552–1562
[3]
McClave SA, Lowen CC, Martindale RG. The 2016 ESPEN Arvid Wretlind lecture: The gut in stress. Clin Nutr, 2018,37(2):19–36
[4]
Rokyta R Jr, Matejovic M, Krouzecky A, et al. Postpyloric enteral nutrition in septic patients: Effects on hepato-splanchnic hemodynamics and energy status. Intensive Care Med, 2004,30(14):714–717
[5]
Gatt M, MacFie J, Anderson AD, et al. Changes in superior mesenteric artery bloodflow after oral, enteral, and parenteral feeding in humans. Crit Care Med, 2009,37(12):171–176
[6]
Evans L, Andrew R, Waleed A, et al. Executive summary: surviving sepsis campaign: international guidelines for the management of sepsis and septic shock 2021. Crit Care Med, 2021,49(11):1974–1982
[7]
Longhitano Y, Zanza C, Thangathurai D, et al. Gut alterations in septic patients: a biochemical literature reviews. Rev Recent Clin Trials, 2020,15(4):289–297
[8]
Blaser AR, Deane AM, Preiser JC, et al. Enteral feeding intolerance: updates in Definitions and Pathophysiology. Nutr Clin Pract, 2021,36(1):40–49
[9]
Berk Takir H, Karakurt Z, Salturk C, et al. Does total parenteral nutrition increasethe mortality of patients with severe sepsis in the ICU? Turk Thorac J, 2015,16(2):53–58
[10]
Lavrentieva A, Kontakiotis T, Bitzani M. Enteral nutrition intolerance in criticallyill septic burn patients. Burn Care Res, 2014,5(12):313–318
[11]
Heyland DK, Ortiz A, Stoppe C, et al. Incidence, risk factors, and clinical consequence of enteral feeding intolerance in the mechanically ventilated critically ill: an analysis of a multicenter, multiyear database. Crit Care Med, 2021,49(1):49–59
[12]
Yu K, Guo N, Zhang D, et al. Prevalence and risk factors of enteral nutrition intolerance in intensive care unit patients: a retrospective study. Chin Med J (Engl), 2022,135(15):1814–1820
[13]
Paul S, Simon H, Marianne C, et al. Feeding the critically ill obese patient: a systematic review protocol. JBI Database Systematic Rev Implement Rep, 2015,13(10):95–109
[14]
Jenkins B, Calder PC, Marino LV. A systematic review of the definitions and prevalence of feeding intolerance in critically ill adults. Clin Nutr ESPEN, 2022,49:92–102
[15]
Xiao Y, Xu L. Prevalence and Risk Factors of Enteral Feeding Intolerance in Critically Ill Patients and the Effectiveness of Preventive Treatments: A Prospective Study. Saudi J Med Med Sci, 2023,11(2):135–142
[16]
Chen T, Wang T, Li Q, et al. Current status and influencing factors of enteral. feeding intolerance in patients with severe acute pancreatitis. Chin J Nurs, 2017,52(6):716–720
[17]
Virani FR, Peery T, Rivas O. Incidence and Effects of Feeding Intolerance in Trauma Patients. JPEN J Parenter Enteral Nutr, 2019,43(6):742–749
[18]
Chen W, Wang H, Chen Y, et al. The independent risk factors of early diarrhea in enteral nutrition for ICU patients. J Int Med Res, 2019,47(10):4929–4939
[19]
Haussner F, Chakraborty S, Halbgebauer R, et al. Challenge to the intestinal mucosa during sepsis. Front Immunol, 2019,10:891–907
[20]
Bordejé ML, Montejo JC, Mateu ML, et al. Intra-Abdominal pressure as a marker of enteral nutrition intolerance in critically ill patients. the PIANE study. Nutrients, 2019,11(11):2616
[21]
Zhao HB, Jia L, Yan QQ, et al. Effect of Clostridium butyricum and Butyrate on Intestinal Barrier Functions: Study of a Rat Model of Severe Acute Pancreatitis with Intra-Abdominal Hypertension. Front Physiol, 2020,11:561061
[22]
Leng Y, Jiang C, Xing X, et al. Prevention of Severe Intestinal Barrier Dysfunction Through a Single-Species Probiotics is Associated with the Activation of Microbiome-Mediated Glutamate-Glutamine Biosynthesis. Shock, 2021,55(1):128–137
[23]
Regli A, Hockings LE, Musk GC, et al. Commonly applied positive end-expiratory pressures do not prevent functional residual capacity decline in the setting of intra-abdominal hypertension: a pig model. Crit Care, 2010,14(04):R128
[24]
Regli A, Mahendran R, Fysh ET, et al. Matching positive end-expiratory pressure to intra-abdominal pressure improves oxygenation in a porcine sick lung model of intra-abdominal hypertension. Crit Care, 2012,16(05):R208
[25]
Silva PL, Ball L, Rocco PRM, et al. Physiological and Pathophysiological. Consequences of Mechanical Ventilation. Semin Respir Crit Care Med, 2022,43(3):321–334
[26]
Santos CL, Moraes L, Santos RS, et al. Effects of different tidal volumes in pulmonary and extrapulmonary lung injury with or without intraabdominal hypertension. Intensive Care Med, 2012,38(03):499–508
[27]
Pelosi P, Luecke T, Rocco PR. Chest wall mechanics and abdominal pressure. during general anesthesia in normal and obese individuals and in acute lung injury. Curr Opin Crit Care, 2011,17(01):72–79
[28]
Gayen S. Malignant Pleural Effusion: Presentation, Diagnosis, and Management. Am J Med, 2022,135(10): 1188–1192
[29]
Cecconi M, Evans L, Levy M, et al. Sepsis and septic shock. Lancet, 2018,392(10141):75–87
[30]
Jacobi J. The pathophysiology of sepsis-2021 update: Part 2, organ dysfunction and assessment. Am J Health Syst Pharm, 2022,79(6):424–436
[31]
De Backer D, Arias Ortiz J, Levy B. The medical treatment of cardiogenic shock: cardiovascular drugs. Curr Opin Crit Care, 2021,27(4):426–432
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