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2007, Number 2

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Med Crit 2007; 21 (2)

Nutritional support in the critically ill: A 20 year five cohort experience

Álvarez MP, Cerón DUW, Sierra UA

Language: Spanish
References: 40
Page: 80-90
PDF size: 94.23 Kb.


ABSTRACT

Objectives: To identify the characteristics of the nutritional supported critically ill; to determine the influence of this support on mortality outcome, and to compare this findings with previous data of our Unit.
Design: A retrospective, comparative study.
Setting: Intensive Care Unit of a teaching hospital.
Patients: Patients admitted to the ICU on 2004. Uncompleted files were excluded, and for the mortality analysis we’ve excluded patients discharged to another hospital, younger than 18 years old, coronary patients, cardiac surgery and burn patients.
Interventions: None.
Methods: The difference between groups was compared with Student’s t test and χ², and analysis of variance was performed with Dunnet’s proof. In-hospital mortality vs expected mortality by APACHE II model was compared with the SMR (Standardized Mortality Ratio), with confidence interval (CI) of 95%.
Main results: Of 428 patients admitted to the ICU on 2004, 358 were included, 183 (51%) were artificially nourished, 150 by the enteral way (82%), 16 by parenteral way (8.7%), and 17 in both ways (9.3%). There weren’t differences between nourished and no-nourished patients on age (p = 0.74), sex (p = 0.91), APACHE II score (p = 0.44) and MODS (p = 0.95). The observed vs. expected mortality were for Parenteral 28.6 vs 28.8%, SMR 0.99 (CI 95%: 0.27 to 2.53); Enteral 14.8 vs 20.8%, 0.71 (0.42 to 1.127); Both enteral-parenteral 23.1 vs 32.6%, 0.7 (0.14 to 2.06); Total nourished 16.8 vs 22.4%, 0.74 (0.48 to 1.1); No-nourished 23.5 vs 26.7%, 0.93 (0.65 to 1.29).
Conclusion: There’s a trend toward reduction in mortality between patients who were nourished by the enteral way and the total of artificially nourished patients. There’s an increase in the quantity of patients nourished by the enteral way and in the total of artificially nourished patients in comparison with previous years, and a reduction in mortality in these groups.


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