Oral Versus Artificial Nutrition Therapy In Critically Ill Patients: A BI-National Prospective Observational Study In Australia And New Zealand.

Abstract

Rationale: Patient characteristics and nutrition provision in those who receive oral nutrition during critical illness is poorly defined. This study aimed to describe differences in patient characteristics and nutrition provision in patients that received oral versus artificial nutrition in the intensive care unit (ICU) and the post-ICU ward. Method(s): A multi-centre, observational study in 44 hospitals across Australia and New Zealand. All adult patients, admitted to the ICU for >= 48 hours over the 7-day screening period were eligible. Patients receiving oral nutrition alone in ICU were compared to those who received enteral (EN) or parenteral nutrition (PN) at any time, termed the 'artificial nutrition group'. Data was assessed daily in ICU on days 1-7 then days 14, 21, 28 in hospital regardless of location (ICU or ward). Data is presented as n (%) or median [IQR]. Result(s): There were 200 patients in the oral group and 209 in the artificial group. Patients receiving oral nutrition alone were older (67 [56-75] vs 61 [48- 72]) years, p<0.001), had a lower APACHE II score (17 [12-22] vs 20 [15-26], p< 0.001), were less likely to be ventilated (57 (28.5%) vs 181 (87%), p<0.001) and had a shorter hospital stay (10.5 [7-17] days vs 22 [12.5-32] days, p<0.001). Patients receiving oral nutrition were less likely to have a nutrition assessment conducted (ICU: 63 (31.5%) vs 169 (81%), p<0.001; ward: 62 (40%) vs 125 (91%), p< 0.001) despite receiving almost half of the energy and protein provision of those receiving artificial nutrition (Table 1). [Formula presented] Conclusion(s): Those who received oral nutrition are less likely to have a nutrition assessment and receive less energy and protein in ICU and on the ward compared to those who receive artificial nutrition. Disclosure of Interest: None declaredCopyright © 2022