Year of Publication

2016

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Melanie Hardin-Pierce

Clinical Mentor

Dr. Theresa Loan

Committee Member

Dr. Chizimuzo Okoli

Abstract

The goal of this research project was to identify the effect of the timing of enteral nutrition (EN) initiation timing on in-hospital mortality, ICU LOS and hospital LOS among patients with septic shock requiring norepinephrine. The study design was a cross-sectional analysis of retrospective electronic health record data. Patients who had received norepinephrine for septic shock were divided into early EN initiation (within 48 hours of ICU admission) and late EN initiation (Greater than or equal to 48 hours after ICU admission) groups. 680 subjects were included; 469 in the early group and 211 in the late group. Demographics, comorbidities, and acuity were similar between the two groups. ICU and hospital LOS (P=.0002, CI 0.7-0.9, P=<.0001, CI 0.59-0.77, respectively) were significantly shorter in the early EN group when controlling for demographics, comorbidities, and acuity. Mortality was not significantly different between the two groups when controlling for demographics, comorbidities, and acuity. There is a need for higher quality research on the subject, but these findings strengthen the argument that EN is safe and potentially beneficial for patients with septic shock requiring norepinephrine.