Enteral vs. Parenteral Nutrition in ICU Which Carries Fewer Complications

Introduction

The choice between enteral (EN) and parenteral nutrition (PN) in critically ill patients has long been a point of clinical debate. A recent retrospective study from Karadeniz Technical University provides valuable insights into the comparative risks and outcomes associated with each feeding method in intensive care units (ICUs). This research highlights the key differences in complication rates, hospital stay durations, and mortality outcomes.
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Key Findings from the Study

A total of 100 ICU patients were retrospectively evaluated 55 received enteral nutrition, and 45 received parenteral nutrition. The study compared parameters including:

• Demographics, reason for ICU admission, comorbidities
• Mechanical ventilation duration, ICU stay
• Complications and 28-day mortality

Clinical Outcome Highlights

• Nosocomial infections, sepsis, and general infection rates were higher in the EN group.
• Length of ICU stay and mechanical ventilation was significantly longer in EN patients (25.04 days vs. 8.33 days in PN).
• 28-day mortality was slightly higher in the PN group (28.9%) than in EN (23.6%), but not statistically significant.
• Patients with surgical conditions were more likely to receive PN; those with medical issues tended toward EN.

Read the full study at https://doi.org/10.29328/journal.ijcar.1001015

Nutritional ComplicationsA Closer Loo

Enteral Nutrition (EN)

• Mechanical complications: 21.8% (aspiration pneumonia, tube obstruction)
• Gastrointestinal issues: High prevalence of nausea (49.1%), constipation (67.3%), diarrhea (36.4%)
• Feeding method: 87.3% via nasogastric tube; 12.7% via PEG/PEJ

Parenteral Nutrition (PN)

• Mechanical risks: 13.3% (catheter-related sepsis, arterial puncture)
• Hepatic dysfunction: Affected 28.9% of PN patients
• Reduced GI-related symptoms, but potential for liver complications over long-term use

According to the American Society for Parenteral and Enteral Nutrition (ASPEN), enteral feeding is preferred when the gastrointestinal tract is functional, but PN remains crucial for patients unable to tolerate EN due to surgical or anatomical constraints.

Clinical Implications and Best Practices

While infection rates were higher with EN, this was largely attributed to longer ICU stays and underlying medical admissions. PN, though associated with hepatic dysfunction, resulted in shorter ICU stays and fewer infectious complications.

A detailed analysis can be found in our main journal article.
For similar insights, browse our nutrition in ICU category.

Conclusio

This comparative study sheds light on the nuanced outcomes of nutritional strategies in ICU patients. The findings suggest that the reason for ICU admission and duration of hospitalization are stronger predictors of complications than the nutritional route itself. Both methods carry distinct risks and must be chosen based on the individual clinical profile.

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