Enteral Beslenen Hastalarda Beslenmeye Ara Veriliş Nedenlerinin Belirlenmesi

Nurcan Uysal, Samiye Mete

Özet


ENTERAL BESLENEN HASTALARDA BESLENMEYE ARA VERİLİŞ NEDENLERİNİN BELİRLENMESİ

ÖZET

Amaç: Enteral beslenen hastalar gastrointestinal intolerans ve prosedürler gibi  çeşitli nedenlerden dolayı beslenme kesintiye uğrayabilir. Bu çalışmanın amacı, kliniklerde enteral beslenen hastalarda beslenmeye ara veriliş nedenlerini belirlemektir.

Gereç ve Yöntem: Araştırma tanımlayıcı tipte planlanmıştır. Veriler bir üniversite hastanesinin Nöroloji ve Göğüs Hastalıkları kliniğinde nazogastrik yoldan enteral beslenen hastalardan elde edilmiştir. Araştırmanın örneklemini 18 yaş üzeri ve nazogastik tüple enteral yoldan yeni beslenmeye başlamış toplam 96 hasta oluşturmuştur. Veriler 1 Temmuz- 31 Aralık 2010 tarihleri arasında toplanmıştır. Araştırmanın verileri, araştırmacılar tarafından literatüre dayalı oluşturulmuş “Enteral Beslenme İzlem Formu” ile toplanmıştır. Verilerin analizinde sayı ve yüzdelik hesabı kullanılmıştır.

Bulgular: On günde toplam 341 kez enteral beslenmeye ara verilmiştir. Çalışmada 10 gün süreyle izlenen hastaların çoğunluğunun iki (%59.4), üç (57.3), dört (54.2) ve beşinci (52.1) günlerde beslenme desteğine ara verildiği tespit edilmiştir. Beslenme tüpüyle ilgili problemler (%26.6)  enteral beslenmede en sık ara veriliş nedeni olup bunu GRV fazlalığı (%24.9), solunum güçlüğü (%18.2), tanısal işlemler (%10.9), yaşam bulgularında gerileme (%7.9), kusma            (%7.7) ve diyare (%3.8) izlemiştir.

Sonuç: Enteral beslenen hastalarda beslenmeye ara verilişin ana nedenleri beslenme tüpüyle ilgili sorunlar ve gastik rezidüel volüm fazlalığıdır. Bunları önlemek için, hemşirelerin ve diğer sağlık personelin enteral beslenme rehberlerini kullanması önerilmektedir.

Anahtar Kelimeler: Enteral beslenme, beslenme eksikliği, hemşirelik.

 

 

 

 

 

 

DETERMINATION OF THE CAUSES FOR INTERRUPTION OF FEEDING IN ENTERAL FED PATIENTS

ABSTRACT

Objective: Patients who receive enteral nutrition may have feedings interrupted due to a variety of reasons such as a procedures and gastrointestinal intolerance. The purpose of this study is to determine the reasons for interruption of feeding in enterally fed patients in clinics.

Methods: The study was planned as a descriptive type. The data were obtained from patients who were enterally fed by nasogastric route in a neurology and chest diseases clinic of a university hospital.  The sample of the study consists of total 96 patients who are over 18 years, new started to enteral feeding with nasogastric tube. The data were collected between 1 July-31 December 2010. The research data were collected by using the "Enteral Nutrition Monitoring Form" based on the literature by the researcher. Number and percentage calculations are used in analysis of data.

Results: It was found that the majority of the patients who were followed for 10 days in the study were interuption in nutritional support during the second (59.4%), third (57.3), fourth (54.2) and fifth (52.1) days. Problems with the feeding tube (26.6%)was the most frequent reason for the enteral feeding to be interrupted, followed by excess gastic residual volumes (24.9%), respiratory distress (18.2%), diagnostic procedures (10.9%), vital signs regression (7.9%), vomiting (7.7%) and diarrhea (3.8%).

Conclusion: The main reasons for interrupting feeding in enteral-fed patients are problems with the feeding tube and excess gastric residual volume. It is recommended that nurses and other health personnel use enteral nutrition guidelines to prevent them.

 

Keywords: Enteral feeding, nutritional deficiency, nursing.

 

 

 


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Referanslar


KAYNAKLAR

Bankhead R, Boullata JI, Brantley S, et al. Enteral nutrition practice recommendations. J Parenter Enter Nutr. 2009;33(2): 122-67.

Boullata JI, Carrera AM, Harvey L, et al. ASPEN safe practices for enteral nutrition therapy. J Parenter Enter Nutr. 2017;41(1): 15-103.

McClave SA, Martindale RG, Vanek VW, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). J Parenter Enter Nutr. 2009;37(5): 277-316.

Savran Y, Limon M, Tokur ME, Cömert B. Erişkin yoğun bakımda entübe hastalarda beslenme yetersizliğine yol açan faktörler ve zamanında yeterli beslenme desteğinin hasta sonuçları üzerine etkisi. Dahili ve Cerrahi Bilimler Yoğun Bakım Derg. 2016; 7(1): 15-20.

Morgan LM, Dickerson RN, Alexander KH, Brown RO, Minard G. Factors causing interrupted delivery of enteral nutrition in trauma intensive care unit patients. Nutr Clin Pract. 2004;19(5): 511-7.

O’Meara D, Mireles-Cabodevila E, Frame F, et al. Evaluation of delivery of enteral nutrition in critically ill patients receiving mechanical ventilation. Am J Crit Care. 2008;17(1): 53-61.

Kim H, Stotts NA, Froelicher ES, et al. Enteral nutritional intake in adult korean intensive care patients. Am J Crit Care. 2013;22(2): 126-35.

Williams TA, Leslie GD, Leen T, Mills L, Dobb GJ. Reducing interruptions to continuous enteral nutrition in the intensive care unit; a comparative study. J Clin Nurs. 2013;(22): 2838-48.

Elpern EH, Luminata S, Peterson S, Gurka DP, Skipper A. Outcomes associated with enteral tube feedings in a medical intensive care unit. Am J Crit Care. 2004;13(3): 221-7.

Kim H, Stotts NA, Froelicher ES, Engler MM, Porter C. Why patients in critical care do not receive adequate enteral nutrition? A review of the literature. J Crit Care. 2012;27: 702-13.

Peev MP, Yeh DD, Quraishi SA, et al. Causes and consequences of interrupted enteral nutrition: a prospective observational study in critically ill surgical patients. J Parenter Enter Nutr. 2015;39(1): 21-7.

Rubinson L, Diette GD, Song X, Brower RG, Krishnan JA. Low caloric intake is associated with nosocomial bloodstream infections in patients in the medical intensive care unit. Crit Care Med. 2004;32(2): 350-7.

Pancorbo-Hidalgo PL, Garcia-Fernandez FP, Ramirez-Perez C. Complications associated with enteral nutrition by nasogastric tube in an internal medicine unit. J Clin Nurs. 2001;10: 482-490.

Persenius MW, Larsson BW, Hall-Lord M. Enteral nutrition in intensive care nurses’ perceptions and bedside observations. Intensive Crit Care Nurs. 2006;22: 82-94.

Kuslapuu M, Jõgela K, Starkopf J, Blaser AR. The reasons for insufficient enteral feeding in an intensive care unit: A prospective observational study. Intensive Crit Care Nurs 2015;31(5): 309-14

McClave SA, Sexton LK, Spain DA, et al. Enteral tube feeding in the intensive care unit: Factors impeding adequate delivery. Crit Care Med. 1999;27(7): 1252-6

Yip KF, Rai V, Wong KK. Evaluation of delivery of enteral nutrition in mechanically ventilated Malaysian ICU patients. BMC Anesthesiol. 2014;14: 127.


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