The Efficacy of an Enteral Access Protocol for Feeding Trauma Patients

Background: Proper enteral access to deliver specialized nutrition support in critically injured patients can be difficult, time consuming, and costly. We designed a protocol with interdisciplinary input to facilitate early enteral access in our trauma patients. Our primary objective was to determine if the protocol improved our ability to obtain small-bowel access in patients within 48 hours of their admission to the surgical intensive care unit (SICU). Secondary objectives were to examine the efficacy of the protocol by evaluating parenteral nutrition (PN) use, adequacy of enteral caloric delivery, and clinical outcomes including pneumonia and sepsis rates, SICU length of stay (LOS), hospital LOS, and mortality before and after its implementation. Methods: The medical records of 51 trauma patients admitted to the SICU, who met inclusion criteria, were reviewed retrospectively and divided into 2 groups. Patients in group 1 were admitted before protocol implementation (1997–1998, n = 17). Patients in grou...