Clinical Outcomes Related to Protein Delivery in a Critically Ill Population

Abstract

Achieving at least 80% of prescribed protein intake may be important to survival and shorter TDA in ICU patients. Efforts to achieve prescribed protein intake should be maximized.

Avaliação da terapia nutricional enteral em pacientes críticos de uma Unidade de Terapia Intensiva

“…Uma menor oferta calórica em pacientes internados em UTI está associada ao aumento nos episódios de hipoglicemia (28)(29)(30) , infecções severas (31) , maior tempo de internação (32) , maiores gastos com a saúde desses indivíduos (33) e aumento nas taxas de mortalidade (31,34) . O consenso canadense para terapia nutricional em paciente crítico preconiza que o acompanhamento diário e o rígido controle do protocolo de nutrição enteral da UTI por parte da EMTN deve facilitar um maior recebimento da dieta prescrita (35) .…”

Enteral Nutrition Feeding Adequacy among Mechanically Ventilated Critically Ill Patients with High Nutrition Risk in a selected Public Hospital in Malaysia : A preliminary study

“…Even with this low level of protein target, our patient only received approximately 62.4% of this target, with the average of approximately 0.75g/kg body weight. This level is dangerously low given the facts that there were a strong association of protein intake and clinical outcomes among critically ill patients 3,28 .…”

“…Given that 88.2% of our high nutrition risk patients were underfed, it is plausible that both feeding inadequacy and disease severity are affecting patients' survival. Many large multi-centre research had been done and confirmed the relationship between feeding adequacy and clinical outcomes after adjusting for disease severity status 2,3,19 , especially in patients with high nutrition risk 6 A Malaysian cohort study on nutritional support practices in ICU is eagerly awaited.…”

“…2,3 However, the International Nutrition Survey 2013 revealed that the prevalence of iatrogenic underfeeding (patients receiving less than 80% of energy and protein requirement) worldwide was 74%. 4 The Nutrition Risk in the Critically Ill (NUTRIC) score has been developed and validated specifically among critically ill patients to identify those who will be harmed the most by iatrogenic (hospital-acquired) malnutrition.…”

Feeding adequacy among Critically Ill Patients in the Intensive Care Unit and Its Association with Clinical Outcomes: A Narrative Review

“…8 It may be more important to ensure protein adequacy as studies have shown that improvement of clinical outcomes is associated with adequate protein intake, even after adjustment for energy adequacy. 9,10 . However, caution also need to be taken to avoid overfeeding patients, which is usually defined as feeding over 110% of energy prescribed, 11 as it is associated with complications such as hyperglycemia, azotemia, hypertriglyceridemia, electrolyte imbalance, immunosuppression, alteration in hydration status, hepatic steatosis, and difficulty waning from mechanical ventilation.…”