Evaluation of Over- and Underfeeding Following the Introduction of a Protocol for Weaning From Parenteral to Enteral Nutrition in the Intensive Care Unit

Background: Over- and underfeeding critically ill patients have significant clinical consequences. These patients are often given a combination of enteral nutrition (EN) and parenteral nutrition (PN), potentially increasing their risk of overfeeding. No published protocol describing the process for weaning from parenteral to enteral feeding and its effects on over- and underfeeding exists. This study aimed to evaluate the introduction of such a protocol. Materials and Methods: A prospective, 2-phase observational study was performed in a 10-bed medical/surgical intensive care unit on patients ventilated for >72 hours and receiving EN and/or PN. Data were collected 6 months before and 2 years after the implementation of a weaning protocol. Underfeeding was defined as energy intake 110% of estimated requirements. Results: Twenty-two patients were fed for a total of 118 days in phase 1, and 29 patients were fed for a total of 272 days in phase 2. Overfeeding occurred more frequently ...