Nutrition practices in Australia and New Zealand in response to evolving evidence: Results of three point-prevalence audits

IF 2.6 3区医学 Q2 CRITICAL CARE MEDICINE

Australian Critical Care Pub Date : 2025-01-01 DOI:10.1016/j.aucc.2024.07.079

Lee-anne S. Chapple PhD, APD , Anneleen Neuts MD , Stephanie N. O'Connor MNSc, RN , Patricia Williams BN, RN , Sally Hurford PG Dip Clinical Research, RN , Paul J. Young PhD, MBChB , Naomi E. Hammond PhD, RN , Serena Knowles PhD, RN , Marianne J. Chapman PhD, BMBS , Sandra Peake PhD, BMBS , the TARGET Investigators, The George Institute for Global Health and the Australian and New Zealand Intensive Care Society Clinical Trials Group

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引用次数: 0

Abstract

Background

The Augmented versus Routine Approach to Giving Energy Trial (TARGET) was a 4000-patient trial in which augmented enteral calorie dose did not influence outcomes.

Aim

We aimed to quantify practice change following TARGET.

Methods

Three single-day, prospective, multicentre, point-prevalence audits of adult patients receiving enteral nutrition (EN) in participating Australian and New Zealand intensive care units at 10:00 AM were conducted: (i) 2010 (before conducting TARGET); (ii) 2018 (immediately before publishing TARGET results); and (iii) 2020 (2 years after TARGET publication). Data included baseline characteristics, clinical outcomes, and nutrition data. Data are n (%), mean ± standard deviation, or median [interquartile range]. Differences in enteral calorie prescription between 2018 and 2020 were compared using the Mann–Whitney test.

Results

The percentage of patients receiving EN (2010 42%, 2018 38%, 2020 33%; P = 0.012) and the prescription of calorie-dense EN formula (≥1.5 kcal/ml) (2010 33%, 2018 24%, 2020 23%; P = 0.038) decreased over time. However, when comparing prepublication and postpublication (2018–2020), calorie dose and calorie density were similar: 22.9 ± 8.6 versus 23.4 ± 12.8 kcal/kg/day (P = 0.816) and <1.5 kcal/ml: 76 versus 77% (P = 0.650), respectively.

Conclusion

In Australian and New Zealand intensive care units, enteral calorie dose and calorie density of prescribed EN were similar before TARGET publication and 2 years later.

查看原文本刊更多论文

澳大利亚和新西兰根据不断变化的证据采取的营养做法：三点普遍性审计的结果。

背景：目的：我们旨在量化 TARGET 试验后的实践变化：我们对参与试验的澳大利亚和新西兰重症监护病房在上午 10:00 接受肠内营养（EN）的成年患者进行了三次单日、前瞻性、多中心、点流行率审计：(i) 2010 年（开展 TARGET 之前）；(ii) 2018 年（TARGET 结果公布前夕）；(iii) 2020 年（TARGET 公布 2 年之后）。数据包括基线特征、临床结果和营养数据。数据单位为 n（%）、平均值 ± 标准差或中位数 [四分位距]。使用 Mann-Whitney 检验比较了 2018 年和 2020 年之间肠内热量处方的差异：接受 EN 的患者比例（2010 年 42%，2018 年 38%，2020 年 33%；P = 0.012）和热量高的 EN 配方（≥1.5 千卡/毫升）处方（2010 年 33%，2018 年 24%，2020 年 23%；P = 0.038）随时间推移有所下降。然而，如果比较出版前和出版后（2018-2020 年），热量剂量和热量密度相似：22.9 ± 8.6 对 23.4 ± 12.8 千卡/千克/天（P = 0.816），结论：在澳大利亚和新西兰的重症监护病房中，在 TARGET 发布之前和 2 年之后，处方 EN 的肠内热量剂量和热量密度相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australian Critical Care NURSING-NURSING

CiteScore

4.90

自引率

9.10%

发文量

148

审稿时长

>12 weeks

期刊介绍： Australian Critical Care is the official journal of the Australian College of Critical Care Nurses (ACCCN). It is a bi-monthly peer-reviewed journal, providing clinically relevant research, reviews and articles of interest to the critical care community. Australian Critical Care publishes peer-reviewed scholarly papers that report research findings, research-based reviews, discussion papers and commentaries which are of interest to an international readership of critical care practitioners, educators, administrators and researchers. Interprofessional articles are welcomed.