Safety of minimizing pre-operative starvation in critically-Ill and intubated trauma patients.

Background: Cessation of enteral nutrition prior to an operation/procedure is the most common reason for feeding interruption in critically-ill trauma patients and contributes to substantial calorie deficits. This study reports on a strategy to increase calorie intake by continuing feeds until transfer for operations/procedures. Methods: Nutrition guidelines were modified in 2006 to allow continuation of feeding in intubated patients up until transfer to the operating room. Prior to 2006, enteral feeding was stopped at least 6 hours prior to surgery. A retrospective cohort design from 2003-2010 compared clinical outcomes in groups of adult trauma subjects before and after guideline changes, and in subjects at other centers without guideline changes. Results: During the first week, subjects in the pre-implementation cohort (n=245) received a median of 3,787 kcal/person/week, while subjects in the post-implementation cohort (n=368) received a median of 6,662 (p

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