Association between early enteral nutrition and clinical outcomes in critically ill obese Indian patients: An observational study

Background: Guidelines for the critically ill obese recommend initiating nutrition support within 24-48 hours of intensive care unit (ICU) admission. However, very few studies have reported the effect of early enteral nutrition (EN) in this population. This study evaluated the impact of initiating EN within 12 hours of ICU admission on clinical outcomes in critically ill obese Indian patients. Methods: The study included 140 intubated critically ill obese patients (WHO-Asian obese BMI classification) with a minimum three-day ICU stay. Patients receiving EN within 12 hours (early EN, n=71) of admission were compared with patients initiated on EN after 12 hours (late EN, n=69). Key outcomes included the percentage of target calories and proteins achieved on day three, total calories and proteins delivered, mechanical ventilation days, ICU length of stay (LOS), LOS-hospital, and mortality. Results: The early EN group received significantly higher target calories (84% vs. 78%; p=0.05) and proteins (79% vs. 72%; p=0.05) on day three. The early EN was associated with significantly fewer mechanical ventilation days (6.5 ± 3.5 vs. 9.01 ± 6.1days; p=0.024), LOS-ICU (10 ± 3.5 vs. 14.2 ± 9 days; p=0.009) and LOS-Hospital (15.5 ± 8.1 vs. 24.9 ± 12.5 days; p=<0.001). Mortality rates were similar (18% vs 16%; p=0.71). Conclusion: In critically ill obese Indian patients, EN initiation within 12 hours of ICU admission leads to shorter mechanical ventilation days, LOS-ICU, and LOS-hospital.