Early Enteral Nutrition and Clinical Outcomes in COPD Patients Requiring Mechanical Ventilation

Fariba Mansouri; Majid Akrami; Neda Faraji; Masoomeh Nataj Majd

doi:10.18502/acta.v61i9.15286

Fariba Mansouri Department of Respiratory, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
Majid Akrami Department of Anesthesiology, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
Neda Faraji Department of Internal Medicine, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
Masoomeh Nataj Majd Department of Anesthesiology, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/acta.v61i9.15286

Keywords: Nutrition; Chronic obstructive pulmonary disease enteral feeding; Critical illness; Patient outcome

Abstract

Early commencement of enteral nutrition (EEN) in critically ill patients requiring mechanical ventilation may improve outcomes. But there is a lack of enough data regarding EEN effects on COPD exacerbation patients’ outcomes. This retrospective study involved 129 COPD exacerbation patients who received invasive mechanical ventilation in ICU. The clinical outcomes were compared based on the timing of enteral nutrition (<48h vs >48h) during 60 days of ICU stay. We surveyed and analyzed mortality, pleural effusion, ventilator-associated pneumonia, weaning failure, cardiac arrhythmias, GI bleeding, electrolyte imbalances, renal dysfunction and length of ICU stay. All analyses were performed using SPSS software version 22.0. 129 COPD-exacerbated patients (EEN group n=66; DEN group n=63) who met the inclusion criteria were enrolled in the study. EEN group had a lower death rate (39% vs 44.4%) than the DEN group, but no significant difference was found in the overall mortality during the 60-day follow-up (P 0.561). The EEN group also had lower ICU stay and pleural effusion rate than the DEN group (P:0.006 and 0.020 respectively). No significant differences were found in other outcomes. Early enteral nutrition might be associated with shorter ICU stay and lower odd ratio of acquisition of pleural effusion in COPD patients requiring invasive mechanical ventilation. EEN could not decrease mortality rate compared with DEN in the current study.