Effect of Early Enteral Nutrition on Clinical Outcomes in an Intensive Care Unit

Background: There is evidence that early enteral nutrition can improve clinical outcomes in patients hospitalized in the intensive care unit. Objectives: The purpose of this study was to evaluate the effect of early enteral nutrition on clinical outcomes in medical patients admitted to the intensive care unit. Materials and Methods: This prospective study was performed on 94 patients admitted to the medical intensive care unit (ICU). The patients were divided into two groups according to nutrition onset. Enteral nutrition for group one was started within the first 48 hours of admission to the ICU and group two received enteral nutrition after the third day of admission to the ICU. Patients were monitored for ICU length of stay, organ failure (SOFA score), aspiration pneumonia, duration of mechanical ventilation and mortality. Results: The average daily caloric intake between the two groups did not differ significantly (P = 0.4). Both groups received more than 75% of the calculated required calorie. The mean duration of hospitalization, occurrences of organ failure and mortality were lower in patients who received their calculated daily nutrition during the first 48 hours of admission (P < 0.05). Regarding ventilator-associated pneumonia, there was no significant difference between the two groups of early and late enteral nutrition. There was no significant difference between the two groups of early and late nutrition in the duration of mechanical ventilation. Logistic regression analysis showed that late nutrition causes a 3.3 times increase in mortality rate, 1.3 times in the length of ICU stay and 1.8 times in organ failure (P < 0.05). Conclusions: Early enteral nutrition within 24 to 48 hours of admission to ICU reduces the duration of hospitalization, organ failure and mortality of the medical patients.