serval:BIB_B900A623688A
Metabolic and Nutritional Characteristics of Long-Stay Critically Ill Patients
10.3390/jcm8070985
000479003300070
31284633
Viana
Marina V.
author
Pantet
Olivier
author
Bagnoud
Geraldine
author
Martinez
Arianne
author
Favre
Eva
author
Charrière
Mélanie
author
Favre
Doris
author
Eckert
Philippe
author
Berger
Mette M.
author
article
2019-07-07
Journal of clinical medicine
2077-0383
2077-0383
journal
8
7
985
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.
Nutrition Risk Screening (NRS-2002)
age
chronic critical illness
diabetes
glucose
nutrition
protein
shock
underfeeding
vasopressors
eng
60_published
true
peer-reviewed
Publication types: Journal Article
Publication Status: epublish
University of Lausanne
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