Abstract
Objectives: We assessed the safety and efficacy of application of an enteral nutrition (EN) protocol in post-esophagectomy patients who required intensive care for more than 7 days. Methods: There was no EN protocol for 24 patients who underwent esophagectomy in 2006. The initiation and adjustment of feeding in those patients were decided by attending physicians once a day without any target goal of EN. An EN protocol was used in 27 patients in 2007. In those patients, EN was initiated on postoperative day 2 or 3, and the feeding dose was increased by 20 kcal/hr in the morning and evening toward 100% of basal energy expenditure (E100) calculated by Harris-Benedict formula. Results: The median durations to achieve EN administration of E100 was 3 days with the protocol, which was significantly shorter than the 6-day period for patients without the protocol (P < 0.001). There was no significant difference in the incidence of diarrhea and residual volumes between the two groups. The use of parenteral feeding was significantly less frequent in patients with the protocol than in patients without the protocol (0% vs. 16.7%, P = 0.03). Conclusions: Our simple EN protocol makes the duration to achieve the target goal of EN significantly shorter without any harmful side effects.
