SUN-PP068: Gastroschisis and Its Challenges to Neonatologist: Multiple Adaptive Systems

Methods: This prospective cohort study included 94 patients on mechanical ventilation and stayed in ICU for 72 h. APACHE II score, SOFA score, prescribed and delivered nutrition during first 7 days ICU admission, and time of EN initiation were collected. Patients were classified using Nutrition Risk In the Critically ill (NUTRIC) score. Outcome variables included mechanical ventilation days, ICU length of stay and mortality. Linear and logistic regressions were used to determine differences in outcomes using SPSS software. Results: EN was initiated 24±28 h of ICU admission and 89% of patients met the guideline of EN initiation within 48 h of admission. Patients received an average of 814±434 kcal and 39±22 g protein per day, corresponding to 52±26% and 53±29% of energy and protein prescription respectively. Feed interruption throughout ICU stay was 47±34 h per patient. The top two common reasons were fasting for intubation or extubation, and high gastric residual volume, which contributed to 26% (12±4 h) and 16% (7±18 h) of total interruptions per patient, respectively. In patients with high NUTRIC score (n = 74), there were no differences in the outcome variables when adjusted for age, gender, APACHE II score, SOFA score and energy-protein adequacy in the first 7 days of ICU admission. Conclusion: A dietitian blanket referral protocol can ensure early EN initiation. This alone is insufficient to achieve adequacy of EN delivered. Feed interruption plays a significant role in affecting nutritional adequacy and should be addressed in the feeding protocol.