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2013, Number 2

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RCAN 2013; 23 (2)

Malnutrition and nosocomial infection in the critically ill patient

Hernández GRA

Language: Spanish
References: 28
Page: 257-267
PDF size: 321.89 Kb.


ABSTRACT

Energy nutrient malnutrition (ENM), also including depletion of essential micronutrients and reduction of body lean mass, is very common in critically ill patients. Nearly 20 – 40% of them show important signs of malnutrition during their stay in a unit specialized in the care of ill patients. ENM negatively impacts upon evolution of the critically ill patient and might place him/her at increased risk of dying. Nutritional status of patients assisted at the Critical Care Polivalent Unit (Men: 66.0%; Ages ≥ 60 years: 32.2%; Trauma: 46.9%) of the “General Calixto García” University (La Habana, Cuba) with ≥ 7 days of hospital stay was determined, and the association between malnutrition and nosocomial infection and condition upon discharge (Alive/Deceased) were assessed. Nutritional status was established after edemas, ascitis and liver enlargement; low lymphocytes counts, and reduced Albumin, Cholesterol, and Creatinine sera values. Nosocomial infection was diagnosed from the isolated/simultaneously occurrence of bronchopneumonia, catheter related-sepsis and urinary infection. Nosocomial infection presented in 70.6% of the patients. Sixty-eight percent of patients were malnourished on the seventh day of unit stay. Nosocomial infection and malnutrition were closely related (OR = 7.76; p ‹ 0.05; CI 95%: 3.47 – 17.37). Likewise, malnourished patients were more prone to die (OR = 3.11; p ‹ 0.05; CI 95%: 1.39 – 6.98). Mortality was dependant upon severity of malnutrition. ENM is a frequent event in the units dedicated to the care of critically ill patients, and is strongly associated with nosocomial infection and in-hospital mortality. Intervention measures should be adopted in order to deal with this situation.


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