Quality indicators in nutrition therapy and clinical outcomes in a neonatal intensive care unit

Abstract

Objective To associate quality indicators in nutritional therapy and pre-determined clinical outcomes in a neonatal unit. Methods A total of 81 premature newborns were monitored regarding the time to initiate nutrition therapy, time to meet energy needs, energy and protein adequacy, cumulative energy deficit, adequacy of the nutritional formula and fasting periods; weight gain, the occurrence of necrotizing enterocolitis, mortality and length of stay in the intensive care unit. The data were analyzed with the Statistical Package for the Social Sciences at 5% significance level. Results The time to start enteral nutrition and the calories infused/kg/day were predictors of length of hospital stay F(2.46)=6.148; p=0.004; R2=0.211; as well as the cumulative energy deficit+birth weight+infused calories/kg/day (F=3.52; p<0.001; R2=0.422); cumulative energy deficit+calories infused/kg/day+fasting time for Enteral Nutrition (F=15.041; p<0.001; R2=0.474) were predictors of weight gain. The time to start enteral nutrition, gestational age and birth weight were inversely associated with the occurrence of necrotizing enterocolitis (β=-0.38; β=-0.198; β=-0.002). Early enteral nutrition predisposed to mortality (β=0.33). Gestational age, birth weight and calories infused/kg/day were inversely related to mortality (β=-0.442; β=-0.004; β=-0.08). Conclusions Considering the associations between indicators and outcomes, routine monitoring of the time to start enteral nutrition, energy adequacy, energy deficit and fasting time is recommended.

Sistematização Da Assistência De Enfermagem a Uma Paciente Em Trabalho De Parto Prematuro

“…(24,25) Os recém-nascidos pré-termos (RNPT) são sujeitos às mais variadas intercorrências neonatais devido a sua exposição prematura a um ambiente, ao qual não estava preparado para interagir. (26) Dentre as possibilidades de complicações intrauterina que o feto pode desenvolver, destaca-se menor tolerância à acidose, maior frequência de apresentações anômalas, risco de trauma fetal, risco de hemorragia intracraniana e risco de sepse. Após o nascimento, podem apresentar dificuldades na sucção, no ganho de peso, no controle da temperatura, bem como problemas respiratórios.…”