Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 20 , ISSUE 6 ( 2016 ) > List of Articles


Postoperative nutrition practices in abdominal surgery patients in a tertiary referral hospital Intensive Care Unit: A prospective analysis

Ipe Jacob, Tejaswini Arunachala Murthy, B. J. Anil

Keywords : Hospital mortality, infection rates, nutrition, outcomes

Citation Information : Jacob I, Murthy TA, Anil BJ. Postoperative nutrition practices in abdominal surgery patients in a tertiary referral hospital Intensive Care Unit: A prospective analysis. Indian J Crit Care Med 2016; 20 (6):319-322.

DOI: 10.4103/0972-5229.183910

License: CC BY-ND 3.0

Published Online: 01-12-2013

Copyright Statement:  Copyright © 2016; The Author(s).


Background: Benefit of early enteral feeds in surgical patients admitted to Intensive Care Units (ICUs) has been emphasized by several studies. Apprehensions about anastomotic leaks in gastrointestinal surgical patients prevent initiation of early enteral nutrition (EN). The impact of these practices on outcome in Indian scenario is less studied. Aims: This study compares the impact of early EN (within 48 h after surgery) with late EN (48 h postsurgery) on outcomes in abdominal surgical ICU patients. Settings and Design: Postabdominal surgery patients admitted to a tertiary referral hospital ICU over a 2-year period were analyzed. Methods: Only patients directly admitted to ICU after abdominal surgery were included in this study. ICU stay>3 days was considered as prolonged; with average ICU length of stay (LOS) for this ICU being 3 days. The primary outcome was in-patient mortality. ICU LOS, hospital LOS, infection rates, and ventilator days were secondary outcome measures. Acute Physiology and Chronic Health Evaluation II scores were calculated. SPSS and Microsoft Excel were used for analysis. Results: Of 91 ICU patients included, 58 received early EN and 33 late EN. Hospital LOS and infection rates were less in early EN group. Use of parenteral nutrition (odds ratio [OR] 5.25, 95% confidence interval (CI); P = 0.003) and number of nil-per-oral days (OR 8.25, 95% CI; P ≤ 0.001) were other predictors of prolonged LOS. Conclusions: Early EN in postabdominal surgery ICU patients was associated with reduced hospital LOS and infection rates. ICU LOS, duration of mechanical ventilation and mortality rates did not vary.

PDF Share
  1. Martindale RG, Maerz LL. Management of perioperative nutrition support. Curr Opin Crit Care 2006;12:290-4.
  2. Casaer MP, Van den Berghe G. Nutrition in the acute phase of critical illness. N Engl J Med 2014;370:1227-36.
  3. Fanaie SA, Ziaee S. Safety of early oral feeding after gastrointestinal anastomosis – A randomized clinical trial. Indian J Surg 2005;67:185-8.
  4. Heyland DK. Nutritional support in the critically ill patients. A critical review of the evidence. Crit Care Clin 1998;14:423-40.
  5. Heyland D, Cook DJ, Winder B, Brylowski L, Van deMark H, Guyatt G. Enteral nutrition in the critically ill patient: A prospective survey. Crit Care Med 1995;23:1055-60.
  6. Adam S, Batson S. A study of problems associated with the delivery of enteral feed in critically ill patients in five ICUs in the UK. Intensive Care Med 1997;23:261-6.
  7. Simpson F, Doig GS. Parenteral vs. Enteral nutrition in the critically ill patient: A meta-analysis of trials using the intention to treat principle. Intensive Care Med 2005;31:12-23.
  8. Moore FA, Feliciano DV, Andrassy RJ, McArdle AH, Booth FV, Morgenstein-Wagner TB, et al. Early enteral feeding, compared with parenteral, reduces postoperative septic complications. The results of a meta-analysis. Ann Surg 1992;216:172-83.
  9. Braga M, Ljungqvist O, Soeters P, Fearon K, Weimann A, Bozzetti F, et al. ESPEN guidelines on parenteral nutrition: Surgery. Clin Nutr 2009;28:378-86.
  10. Perioperative total parenteral nutrition in surgical patients. The Veterans Affairs Total Parenteral Nutrition Cooperative Study Group. N Engl J Med 1991;325:525-32.
  11. Lewis SJ, Andersen HK, Thomas S. Early enteral nutrition within 24 h of intestinal surgery versus later commencement of feeding: A systematic review and meta-analysis. J Gastrointest Surg 2009;13:569-75.
  12. Heyland DK, Dhaliwal R, Drover JW, Gramlich L, Dodek P; Canadian Critical Care Clinical Practice Guidelines Committee. Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients. JPEN J Parenter Enteral Nutr 2003;27:355-73.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.