Efficacy of Tube Feeding in Supplying Energy Requirements of Hospitalized Patients

Abstract

During a 6-week period, all adult patients in a university hospital receiving ready-to-feed nasoenteric tube feeding formula were prospectively studied. The study objective was to determine each patient''s caloric intake from tube feeding relative to their energy needs and to identify factors causing decreased feeding intake. Each of 35 patients was visited at least once daily to determine their volumetric intake of tube feeding formula. Daily review of patient care records and nursing interviews were used to identify interruptions in therapy. Patient''s basal energy expenditures (BEE) were calculated using the Harris-Benedict equation. Calorie goals were set by members of the Nutrition Support Service or clinical dietitians. Intakes averaged 1095 .+-. 41 Kcal (SEM) per day or 61% of their mean calorie goal of 1791 .+-. 41 Kcal. Mean daily calorie intake was statistically different (p < 0.05) from mean energy goal on patient study days 1 through 5, 7, and 8. Only 6 of the 35 patients achieved an intake of 100% of their energy goal on any day of therapy. Calorie goals averaged 1.4 times BEE. Mean daily calorie intake did not exceed BEE until study day 10. Eighteen % of potential feeding time was lost due to temporary feeding interruptions; primarily inadvertent extubation (4.6%), gastrointestinal intolerance (4.7%), medical procedures requiring discontinuation feeding (2.8%), and feeding tube positioning difficulties (1.5%). In addition, physicians orders only 75% of calculated energy goals. These data indicate that tube feeding therapy, when provided under usual hospital conditions, does not meet patient''s energy requirements.