Causes and impacts of interrupted enteral nutrition in critically ill patients: A secondary analysis of a cluster‐randomized controlled trial

BACKGROUND: Malnutrition due to interruption of enteral nutrition remains a prevalent issue in the intensive care unit (ICU). AIM: This study aimed to determine the frequency and causes of enteral nutrition interruption (ENI)and its impact on implementing enteral nutrition. STUDY DESIGN: This is a secondary analysis of a multicentre, cluster-randomized controlled trial (N = 2772). This secondary analysis included patients in the ICU for at least 72 h and receiving total enteral nutrition. The causes of ENI were defined as (1) feeding intolerance, (2) diagnostic and therapeutic procedures and (3) others. Multiple linear regression analyses investigated the association between ENI and nutrition intake. RESULTS: A total of 1331 patients were included for analysis. Approximately 18.63% of the patients experienced at least one episode of ENI. The main cause of ENI was diagnostic and therapeutic procedures. Energy intake was 17.54 ± 6.85 versus 16.64 ± 7.06 (p = .065) among patients with and without ENI, and the protein intake was 0.69 ± 0.27 versus 0.64 ± 0.27 (p = .016). Multiple linear regression analysis revealed that ENI was significantly associated with diminishing energy and protein intake (B = -1.012, 95% CI -1.857 to -0.167, p = .019; B = -0.050, 95% CI -0.083 to -0.017, p = .003, respectively). CONCLUSIONS: Based on this multicentre study about ENI, the incidence of interruptions in enteral nutrition was 18.6%, with diagnostic and therapeutic procedures being the leading causes. The occurrence of interruptions in the delivery of enteral nutrition leads to a reduction in the nutritional intake of critically ill patients. RELEVANCE TO CLINICAL PRACTICE: Critical care nurses should establish comprehensive nutrition support protocols and strengthen the training of department nurses, equipping them with the skills to effectively prevent and manage ENI. This is essential for actively achieving feeding goals and improving the outcomes of ICU patients.