The Relationship between Enteral Nutrition Formula Composition, Feeding Tube Placement Site, and the Start of Enteral Feedings on the Development of Ventilator Associated Event in an Adult Intensive Care Unit

THE RELATIONSHIP BETWEEN ENTERAL NUTRITION FORMULA COMPOSITION, FEEDING TUBE PLACEMENT SITE, AND THE START OF ENTERAL FEEDINGS ON THE DEVELOPMENT OF VENTILATOR ASSOCIATED EVENT IN AN ADULT INTENSIVE CARE UNIT by Jessica M. Alexander Background: Ventilator associated pneumonia (VAP) is a major cause of morbidity, longer intensive care unit (ICU) stay, increased duration of mechanical ventilation, and increased healthcare cost in critically ill patients. Critically ill patients are at increased risk for malnutrition, which is associated with impaired immune function, impaired ventilator drive and weakened respiratory muscles. Malnutrition has been thought to increase the risk of VAP due to bacterial translocation from the gastrointestinal tract to the lungs. Previous research that has evaluated the effect of enteral nutrition on malnutrition associated with VAP has been inconsistent in part because of the subjectivity of the old definition of VAP. In 2013, the Center for Disease Control and Prevention (CDC) developed a new definition for the diagnosis of VAP, which includes three tiers of a ventilator associated event (VAE); ventilator associated condition, infection-related ventilator-associated complication, or possible or probable VAP). The purpose of this study is to retrospectively examine the relationship between enteral formula, tube-feeding placement site, time of tube feeding initiation and the incidence of VAE using this new CDC definition.