Importance of nutritional assessment tools in the critically ill patient: A systematic review

Domenech-Briz, Vicente; Gea-Caballero, Vicente; Czapla, Michał; Chover-Sierra, Elena; Juárez‐Vela, Raúl; Arnedo, Ivan Santolalla; Blasco, Víctor J. Villanueva; Sánchez-González, Juan Luis; Martínez-Sabater, Antonio

doi:10.3389/fnut.2022.1073782

Cited by 9 publications

(6 citation statements)

References 47 publications

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“…The results of our study indicate that the nurses’ functions were more related to the onset of EN, its management and defense (such as early onset) [ 46 , 46 , 48 , 49 , 51 , 52 , 56 , 61 ], not showing an assessment at the admission of the nutritional status of the patients or using the tools proposed by ASPEN, ESPEN or scientific evidence [ 16 , 18 , 22 , 25 , 68 ]. These findings coincide with the scientific literature [ 19 , 63 , 65 , 68 ], where it is shown that nurses consider nutritional care less important and do not take into account the application of scales or instruments to assess whether or not patients are at risk of malnutrition. In addition, the highest knowledge scores were associated with the items on the implementation of interventions (initiation of EN, management of EN), followed by the prevention of complications.…”

Section: Discussionmentioning

confidence: 99%

Knowledge Level of ICU Nurses Regarding Nutritional Assessment of Critically Ill Patients: A Systematic Review

Doménech Briz,

Gea-Caballero,

Chover-Sierra

et al. 2024

Nursing Reports

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Background: Nutritional assessment on admission of critical patients is of vital importance to determine critical patients in whom there is a risk of malnutrition. Currently, it has been detected in most of the patients admitted to the Intensive Care Unit (ICU) that 60% of the daily calories are not achieved. Nurses play an essential role in the comprehensive assessment of the patient, including the nutritional area; however, significant deficits have been detected in some knowledge regarding Enteral Nutrition (EN). Objective: We aim to determine the level of knowledge of nurses in the nutritional assessment of critically ill patients. Methodology: A systematic review of the scientific literature was conducted using the PRISMA statement. Between January 2017 and February 2023, articles were rescued from the electronic databases “Pubmed”, “Scopus” and “The Cochrane Library”, which analyzed the level of knowledge of ICU nurses regarding nutritional assessment. Results: Most of the results found showed that nurses had deficient levels of knowledge in relation to nutritional assessment and practices. Interventions related to nutritional assessment were scarce, in contrast to those associated with the management of Nasogastric Tube (NGT) or patient positioning. Conclusions: The level of knowledge described was low or inadequate in relation to the care associated with the nutritional assessment of critically ill patients. The use of scales to assess the risk of malnutrition was not reported. This study was prospectively registered at PROSPERO on 25/10/2023 (insert date) with registration number CRD: 42023426924.

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Section: Discussionmentioning

confidence: 99%

Knowledge Level of ICU Nurses Regarding Nutritional Assessment of Critically Ill Patients: A Systematic Review

Doménech Briz,

Gea-Caballero,

Chover-Sierra

et al. 2024

Nursing Reports

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“…This https://jicem.journals.ekb.eg/ was in agreement with Ferrie, et al [14] who reported that there was a significant relation between SGA and the need to MV with a higher SGA score was significantly associated with more days of MV. Also, Domenech-Briz V, et al [13] reported that, SGA-C, decreased TSF and MAC were significantly associated with additional days of MV.…”

Section: Aki: Acute Kidney Injurymentioning

confidence: 95%

“…There was a significant association between the advanced grade of SGA (grade C) and the need to MV (p-value 0.001). (Table 4) Individuals may also observe a decrease in body weight, up to 10 kg, based on the LOS [13] .…”

Section: Aki: Acute Kidney Injurymentioning

confidence: 99%

Impact of Malnutrition in Critically Ill Patients on Intensive Care Unit

Eldehily,

Tawfik,

Elkholy

et al. 2023

The Egyptian Journal of Intensive Care and Emergency Medicine

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Background: Malnutrition is one of the major problems during the stay in the intensive care units (ICUs). Critically ill patients are at high risk of developing malnutrition, associated with worse clinical outcomes. This work aimed to detect the severity of malnutrition in critically ill patients by using the Subjective Global Assessment score (SGA) and its association with the length of ICU stay and mortality. Methods: This prospective cohort observational study was carried out on 50 patients aged >18 years old, both sexes, with clinical criteria of malnutrition, involuntary weight loss, low body mass index, decreased mass of muscles, history of decreased food intake or absorption and inflammation or acute disease or injury with severe inflammation. All patients were subjected to mid-arm circumference (MAC), triceps skin fold (TSF) and hand grip strength . Results: The mean length of stay in ICU was 13.5±11.2 days. 18 patients needed mechanical ventilation (MV) representing 36% of cases with mean ventilation days 10.7±7.1, and the mortality proportion 34%. A statistically substantial correlation existed between mortality, smaller MAC (P = 0.001), and TSF (P = 0.001). In addition, the Handgrip was lower in mortality but didn't reach statistical significance (P = 0.091). A substantial association existed between the advanced grade of SGA (grade C) and mortality (P = 0.001). Conclusions: There was a strong association between mortality in critically ill patients and smaller triceps skin fold, MAC. Severe malnutrition in critically ill patients SGA (grade C) was significantly associated with mortality and the need for MV .

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“…The recent guidelines from the American Society for Parenteral and Enteral Nutrition (ASPEN) recommend classifying nutritional risk using assessment tools such as Nutrition Risk Screening 2002 (NRS 2002), the Malnutrition Universal Screening Tool (MUST), the Nutrition Risk in the Critically Ill score (NUTRIC), or its modified version (mNUTRIC), to ascertain baseline nutritional status and to inform individualized nutritional management 4 . The mNUTRIC, widely used and validated across numerous clinical studies, correlates with clinical outcomes including mortality and adverse events in the intensive care unit 16 – 18 . In critically ill patients with an mNUTRIC score of ≥ 5, early caloric supplementation has been linked to reduced mortality and morbidity by providing higher energy and protein, and by facilitating the rapid achievement of caloric goals 19 – 22 .…”

Section: Introductionmentioning

confidence: 99%

Comparative efficacy of peptide-based versus standard polymeric enteral nutrition in ICU patients at high nutritional risk: a multicenter randomized controlled trial

Bhurayanontachai,

Wacharasint,

Somboonviboon

et al. 2024

Sci Rep

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Within intensive care units (ICU), the administration of peptide-based formulas (PBF) may confer nutritional advantages for critically ill patients identified with heightened nutritional risk. This investigation aimed to ascertain the efficacy of PBF in comparison to standard polymeric formulas (SPF) among this patient cohort. A double-blind, randomized controlled trial was conducted across three ICUs, encompassing 63 adult patients characterized by elevated modified Nutrition Risk in Critically Ill (mNUTRIC) scores. Enrollment occurred promptly subsequent to ICU admission, with participants allocated to receive either PBF or SPF. Primary outcome was the duration to achieve caloric targets. Secondary outcomes involved the evaluation of mean daily gastric residual volume, mechanical ventilation period, infection rates within the ICU, length of hospitalization, mortality rates, nutritional status and inflammatory markers, specifically serum albumin and interleukin-6 levels. Patients in the PBF group reached their caloric targets more expeditiously compared to the SPF group (2.06 ± 0.43 days versus 2.39 ± 0.79 days; p = 0.03). No significant differences were discernible between the groups regarding gastric residual volume, duration of mechanical ventilation, ICU length of stay, mortality, or infection rates. Both cohorts exhibited minimal adverse effects and were devoid of any instances of abdominal distension. While not reaching statistical significance, the observed trends in albumin and interleukin-6 levels suggest a potential advantage of PBF utilization. The implementation of PBF enabled swifter attainment of caloric goals in ICU patients at high nutritional risk without adversely impacting other clinical parameters. Given its favorable tolerance profile and potential immunomodulatory properties, PBF may be considered a valuable nutritional intervention in this setting.Thai Clinical Trials Registry TCTR20220221006. Registered 21 February 2022, https://www.thaiclinicaltrials.org/show/TCTR20220221006.

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Importance of nutritional assessment tools in the critically ill patient: A systematic review

Cited by 9 publications

References 47 publications

Knowledge Level of ICU Nurses Regarding Nutritional Assessment of Critically Ill Patients: A Systematic Review

Knowledge Level of ICU Nurses Regarding Nutritional Assessment of Critically Ill Patients: A Systematic Review

Impact of Malnutrition in Critically Ill Patients on Intensive Care Unit

Comparative efficacy of peptide-based versus standard polymeric enteral nutrition in ICU patients at high nutritional risk: a multicenter randomized controlled trial

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