Nutritional adequacy in critically ill adults receiving noninvasive ventilation: A descriptive cohort study.

Abstract

Background: Noninvasive ventilation (NIV) is increasingly being used in critical care, yet limited evidence exists guiding nutrition practices for patients who are critically ill receiving NIV. This study aimed to describe the nutrition practices and adequacy of nutrition intake among patients who are critically ill receiving NIV.

Methods: This descriptive cohort study included adult patients admitted to critical care who received NIV on ≥3 consecutive days. Prospectively recorded clinical data were retrospectively extracted from electronic medical records and compared between patients who received solely noninvasive ventilation (NIV only) and those who received invasive mechanical ventilation (IMV) and were extubated onto noninvasive ventilation (post-IMV group).

Results: Of the 220 patients included (107 NIV only; 113 post-IMV), 142 (64.5%) received exclusive oral nutrition, 66 (30.0%) received artificial nutrition support, and 12 (5.5%) received no nutrition. Enteral nutrition was more prevalent in the post-IMV group (36 [31.9%] vs NIV only 19 [17.8%]; P = 0.01), whereas exclusive oral nutrition was more prevalent in the NIV-only group (86 [80.4%] vs post-IMV 66 [58.4%]; P < 0.001). Most patients who received purely exclusive oral nutrition (n = 152) had inadequate intake (94 [61.8%]).

Conclusion: Most patients with critically illness receiving NIV received exclusive oral nutrition, which was found to be inadequate in the majority. Patients receiving NIV represent a nutritionally at-risk population, and future studies are needed to understand the barriers to oral intake and the feasibility, safety, and effectiveness of enteral nutrition.