Comparison of nutrition related complications of patient groups whose had supported with enteral and parenteral nutrition in intensive care unit

Nutritional support in intensive care patients have become an indispensible part of treatment. The oral intake which is a natural nutritional pathway is usually not possible for intensive care patients. Therefore intensive care patients are usually fed by enteral or parenteral route. Although emphasizing that nutritional support is beneficial for preventing complications during to stay in intensive care unit, feeding with these nutrition types also has its own complications The aim of this study is to retrospectively investigate the complications related to nutrition, duration of stay in intensive care unit, duration of stay in mechanical ventilator, nosocomial infection and sepsis development rate, mortality and morbidity in intensive care patients who have only enteral and only parenteral nutritional support during the treatment. The files of 100 patients followed and treated in our intensive care unit were retrospectively reviewed. Two groups were separated: 55 patients fed only enteral nutrition and 45 patients fed only parenteral nutrition. Patients data were recorded until discharged from the intensive care unit or die. The demographic data, cause of admission, comorbid diseases, laboratory values which recorded at the beginning of the intensive care stay, morbidities during the stay in intensive care unit and the comparison of these between two groups were provided and the own complications of these two groups were examined. As a result, the rates of nosocomial infection development, presence of infection, development of sepsis, duration of mechanical ventilation and intensive care unit stay were found statistically and significantly higher than in patients who fed by enteral nutrition according to patients who fed by parenteral nutrition. When the reason for admission to intensive care unit is considered, it was observed that the patients who were fed by enteral nutrition were followed for mostly medical reasons and the ones who were fed by parenteral nutrition were followed for mostly surgical reasons, and it was statistically and significantly higher ratio in the two groups. Although there was a higher mortality rate in the PN group, there was no statistically significant difference between the two groups. There was also no statistically significant difference between the two groups according to development of hyperglycemia and hypoglycemia. In this study, the rate of nosocomial infection development, presence of infection and sepsis development were higher in the group of patients who were fed enteral route which is more physiologically and normally expected to develop less complications. We believe that the reason for this evidence is related to the fact that the patients who are fed with enteral route are mostly followed up by the medical reasons than from surgical reasons, and as a result of this, the intensive care unit stay and duration in mechanical ventilator is longer in the group of enteral nutrition. At the same time we conclude that patients who are fed parenteral nutrition have shorter duration of intensive care stay and mechanical ventilator stay is related to mostly following with surgical reasons, and therefore, the rate of nosocomial infection development, presence of infection and sepsis development are less common in the group of parenteral nutrition. As a result, we conclude that intensive care unit stay and reason for admission are more effective than the route of enteral or parenteral nutrition in the development of mortality and infection in ICU patients.