A 10-YEAR SURVEY OF NUTRITIONAL SUPPORT IN A SURGICAL ICU - 1986-1995

Total parenteral nutrition (TPN) has long been considered the optimal nutrition technique in critically ill patients, but recently the use o f enteral nutrition (EN) has increased. This study describes the evolu tion of the different nutritional support techniques in a surgical int ensive care unit (ICU) in a university hospital, through (1) a global survey over 10 y assessing the evolution of the use of EN and TPN, and (2) a prospective study performed over 6 mo. Severity of illness and diagnostic categories were stable (n = 11 539 patients). From 1986 to 1990, the proportion of TPN administered increased from 10-25% of ICU days, decreasing to 10% thereafter. EN was used in about 5% of ICU day s in 1986, and had increased to 30% of total ICU treatment days in 199 5. The proportion of nutrients actually delivered to the patients was 75% with EN and 88% with TPN. Major changes in nutritional support hav e been observed since 1986. The frequency of nutritional support provi ded in general has increased to 40% of ICU treatment days. TPN has bee n largely overtaken by EN, with the risk of insufficient energy delive ry, related to the difficulties of EN in the critically ill. These res ults reinforce the importance of continuous quality control by daily a ssessment of nutrient supply. (C) Elsevier Science Inc. 1997.