Dr. Mark DeLegge recently traveled to Hattiesburg, Miss., where he presented on the topic of early enteral feeding to a group of pharmacists, physicians, nurses and dietitians at Forrest General Hospital. This was an invited lecture at the request of the hospital’s dietitians and nutrition support team.
The highlight of the presentation focused on the use of gut, specifically stimulating the imbedded immune system by the use of enteral nutrition. Discussed in the presentation were early enteral feeding’s impact on clinical outcomes, impediments to delivering enteral feeding in the intensive care unit and the science of enteral access. Dr. DeLegge stressed that “there needs to be a major shift in the perception of nutrition, specifically enteral nutrition, and its importance to maximizing clinical outcomes. Dietitians and nutrition specialists need to take the lead role in driving their patient care teams down the road of early enteral access and early enteral nutrition. Frankly, there are drugs that don’t achieve the same level of improvement in clinical outcomes in the critically ill patients that can be achieved with early enteral nutrition.”
There was quite a bit of discussion about the need for a feeding protocol in the ICU to encourage the use of early enteral nutrition and the need for clinicians to stop using gastric residual volumes below 500 cc as a reason to withhold or terminate the delivery of enteral nutrition. All in attendance agreed that the ASPEN/SCCM guidelines certainly set the groundwork for earlier, more aggressive use of enteral nutrition.
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