(1) Good initial weight loss with moderate late regain, anemia, and multiple nutrient deficits was the common pattern. (2) Massive weight loss, frequent vomiting, dumping syndrome, and women in reproductive age were risk factors for hemoglobin or vitamin deficits, whereas superobesity, diabetes, and use of multiple drugs were associated with EWL result. (3) Most laboratory tests became stable by 2 years and along with BMI correlated with late EWL. (4) Two-year nutritional investigation is especially recommended because of its long-term predictive value.
ObjectivesTo evaluate the incidence of constipation in critical patients on enteral nutrition in a hospital intensive care unit and to correlate this incidence with the variables found for critical patients. MethodsThe present investigation was a retrospective analytical study conducted in the intensive care unit of Hospital Regional da Asa Norte (DF) via the analysis of medical records of patients admitted during the period from January to December 2011. Data on the incidence of constipation and enteral nutritional support, gastrointestinal changes, stool frequency, ventilatory support, and outcomes were collected and analyzed. ResultsThe initial sample consisted of 127 patients admitted to the unit during the period from January to December 2011. Eighty-four patients were excluded, and the final sample consisted of 43 patients. The incidence of constipation, defined as no bowel movement during the first 4 days of hospitalization, was 72% (n=31). The patients were divided into a control group and a constipated group. The group of constipated patients reached the caloric target, on average, at 6.5 days, and the control group reached the caloric target in 5.6 days (p=0.51). Constipation was not associated with the length of hospital stay, suspension of nutritional support, or outcome of hospitalization. There was an association between evacuation during hospitalization and a longer duration of hospitalization for a subgroup of patients who did not evacuate during the entire period (p=0.009). ConclusionThe incidence of constipation in the unit studied was 72%. Only the absence of evacuation during hospitalization was associated with longer hospital stays. Constipation was not associated with the length of hospital stay, suspension of nutritional support, or outcome of hospitalization.
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INTRODUÇÃO: O monitoramento dos parâmetros realizados na terapia nutricional contribui para melhoria da assistência, sendo o indicador de qualidade uma ferramenta prática e de baixo custo para este fim.OBJETIVO: Realizar uma revisão crítica da literatura sobre os indicadores de qualidade em terapia nutricional em terapia intensiva.MÉTODOS: Foi procedido um levantamento bibliográfico de artigos científicos até 2014 publicados nas bases de dados conforme os descritores em Ciências da Saúde, com as palavras qualityindicators OR healthindicators AND enteral nutrition.RESULTADOS: A busca pela qualidade em saúde ocorreu através da acreditação hospitalar. O indicador de qualidade é uma ferramenta utilizada na etapa de monitoramento e controle no processo da busca da qualidade em serviço. A Força Tarefa de Nutrição Clínica publicou trinte e seis indicadores de qualidade em terapia nutricional. Na literatura, são escassos os trabalhos que avaliaram indicadores de qualidade em terapia nutricional em Unidade de Terapia Intensiva, sendo o indicador mais avaliado o que mostra a adequação calórica e proteica da nutrição enteral entre o prescrito e o administrado, que mostrou uma variação de 74 a 89% de adequação, com melhora do resultado após um ano de acompanhamento.CONSIDERAÇÕES: Indicador de qualidade em terapia nutricional é um assunto recente na literatura, portanto, foram poucos os estudos encontrados nas bases de dados. Ainda assim, foi possível concluir que a aplicação dos indicadores de qualidade em terapia nutricional pode contribuir para melhoria da assistência nutricional aos acientes criticamente enfermos.
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