Nursing Implications of Enteral Nutrition Timing in Sepsis Patients Stratified by Modified NUTRIC Score: A Retrospective Observational Study.
Shu Zhou, Dingding Zhang, Li Weng and 7 others
PMID 41673981WHAT IT FOUND
In low-risk sepsis patients, enteral nutrition timing showed no significant ICU mortality difference.
In high-risk patients, mortality was lower with EN at 24-48 hours than before 24 hours or after 48 hours.
Key findings
01For low-risk patients, EN timing had no significant difference in ICU mortality, mechanical ventilation duration, ICU stay, hospital stay, or feeding intolerance.
02For high-risk patients, ICU mortality was lower when EN began at 24-48 hours than when it began before 24 hours or after 48 hours.
03For high-risk patients, feeding intolerance was reported as 45.5% with EN initiated during 24 h, 44.44% within 24-48 h, and 25.25% after 48 h.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was retrospective and observational, so it can show associations but cannot prove that enteral nutrition timing caused the differences. Patients who died or did not receive enteral nutrition within 7 days were excluded, so the results do not apply to them. The main outcome was ICU mortality, not 28-day mortality, because of data limitations. No sample size calculation was performed, which may have introduced statistical bias. The low-risk and high-risk groups differed in age, comorbidities, APACHE II scores, SOFA scores, septic shock, and vasopressor use, so other factors may explain outcome differences.
Declared interests
Funding came from National High Level Hospital Clinical Research Funding, the National Key R&D Program of China, and the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences. The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that starting enteral nutrition at 24 to 48 hours reduces ICU mortality for all sepsis patients. The mortality association was seen only in high nutritional risk patients, low-risk patients showed no significant difference, and the study was observational with exclusions that limit generalisation.