Metabolic and Nutritional Characteristics of Long-Stay Critically Ill Patients

Details

Serval ID
serval:BIB_B900A623688A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Metabolic and Nutritional Characteristics of Long-Stay Critically Ill Patients
Journal
Journal of clinical medicine
Author(s)
Viana Marina V., Pantet Olivier, Bagnoud Geraldine, Martinez Arianne, Favre Eva, Charrière Mélanie, Favre Doris, Eckert Philippe, Berger Mette M.
ISSN
2077-0383 (Print))
ISSN-L
2077-0383
Publication state
Published
Issued date
07/07/2019
Peer-reviewed
Oui
Volume
8
Number
7
Pages
985
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
insufficient feeding is frequent in the intensive care unit (ICU), which results in poor outcomes. Little is known about the nutrition pattern of patients requiring prolonged ICU stays. The aims of our study are to describe the demographic, metabolic, and nutritional specificities of chronically critically ill (CCI) patients defined by an ICU stay >2 weeks, and to identify an early risk factor.
analysis of consecutive patients prospectively admitted to the CCI program, with the following variables: demographic characteristics, Nutrition Risk Screening (NRS-2002) score, total daily energy from nutritional and non-nutritional sources, protein and glucose intakes, all arterial blood glucose values, length of ICU and hospital stay, and outcome (ICU and 90-day survival). Two phases were considered for the analysis: the first 10 days, and the next 20 days of the ICU stay.
parametric and non-parametric tests.
150 patients, aged 60 ± 15 years were prospectively included. Median (Q1, Q3) length of ICU stay was 31 (26, 46) days. The mortality was 18% at ICU discharge and 35.3% at 90 days. Non-survivors were older (p = 0.024), tended to have a higher SAPSII score (p = 0.072), with a significantly higher NRS score (p = 0.033). Enteral nutrition predominated, while combined feeding was minimally used. All patients received energy and protein below the ICU's protocol recommendation. The proportion of days with fasting was 10.8%, being significantly higher in non-survivors (2 versus 3 days; p = 0.038). Higher protein delivery was associated with an increase in prealbumin over time (r <sup>2</sup> = 0.19, p = 0.027).
High NRS scores may identify patients at highest risk of poor outcome when exposed to underfeeding. Further studies are required to evaluate a nutrition strategy for patients with high NRS, addressing combined parenteral nutrition and protein delivery.
Keywords
Nutrition Risk Screening (NRS-2002), age, chronic critical illness, diabetes, glucose, nutrition, protein, shock, underfeeding, vasopressors
Pubmed
Web of science
Open Access
Yes
Create date
21/07/2019 16:11
Last modification date
21/09/2019 6:08
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