Efficacy and Challenges of Enteral Nutrition in Critically Ill Patients: Role of Nursing and Clinical Protocols

Abstract

Introduction: Enteral nutrition (EN) was defined as a key strategy to prevent malnutrition and support the recovery of critically ill patients. This intervention allowed maintaining the functionality of the digestive tract and preserving the intestinal barrier, reducing septic complications and improving clinical outcomes. However, studies reported significant discrepancies between the volume of EN prescribed and the volume actually administered, which affected the necessary nutritional intake and compromised the effectiveness of the treatment.
Development: The administration of EN in critically ill patients depended on technological advances such as the use of small-bore catheters, infusion pumps and specialized nutritional formulas designed to meet individual needs. However, mechanical complications arose, such as catheter obstruction and ulceration; gastrointestinal complications, such as diarrhea and vomiting; and metabolic and psychological risks. These complications were exacerbated by failures in the implementation of adequate protocols and lack of continuous monitoring. The role of the nursing staff was decisive in the execution of care before, during and after NE administration, highlighting the importance of hygiene, correct patient positioning and the use of aseptic techniques. In addition, the need for constant training to optimize clinical practices was highlighted.
Conclusions: NE was consolidated as an effective intervention in the management of critically ill patients, although its success depended on correct planning, supervision and updating of health teams. The protocolization of procedures and continuous training of personnel were identified as fundamental pillars to maximize the benefits of this practice, reduce complications and guarantee better clinical and economic results.