Evaluation of Patient's Energy Intake between Different Types of Formulas in the First Week of Starting Enteral Feeding in Intensive Care Unit Patients

Background: Adequate energy intake is an important factor in intensive care unit (ICU) patients, and it can decrease the patients' complications, length of hospitalization, mortality and health care costs. Choosing an appropriate type of formula may be effective in providing the sufficient energy for these patients. Objectives: This study aimed to assess the adequacy of energy intake, and to investigate the effect of different types of the formulas on the calorie intake and gastric residual volumes (GRV) in ICU patients in the first week of starting enteral feeding. Methods: This prospective observational study was conducted on 128 ICU patients of two hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. The patients were randomly assigned to one of the four groups of formulas including Ensure, Entrameal standard, Nutricomp standard and Enterameal high fiber formulas. Energy intake and GRV were recorded daily for 7 consecutive days from the beginning of enteral feeding. Results: About 85% of the patients had traumatic brain injury. The average calculated energy requirement of the patients was 2293 kcal while the average energy intakes in seven days, and on the last day were 668 and 977 kcal, respectively. Only two patients (1.5%) received nearly all their energy requirement in the last day, however, only 5.5% and 35% of the subjects received ≥ 60% and ≥ 80% of their energy requirement, respectively. Enterameal high fiber formula was associated with a significant increase in GRV compared to Ensure formula (p = 0.02), but no significant relationship was found between calorie intake and gastrointestinal symptoms. No statistically significant difference was found in the energy intake between the four types of formulas. Conclusion: It seems that enteral feeding in our ICUs is not successful in practice using the common available formulas. More attention should be paid to the incomplete delivery of the prescribed enteral nutrition in ICU patients.