Nutrition Risk in Critically Ill Versus the Nutritional Risk Screening 2002: Are They Comparable for Assessing Risk of Malnutrition in Critically Ill Patients?

Canales, Cecilia; Elsayes, Ali; Yeh, D. Dante; Belcher, Donna; Nakayama, Anna; McCarthy, Caitlin; Chokengarmwong, Nalin; Quraishi, Sadeq A.

doi:10.1002/jpen.1181

Cited by 54 publications

(76 citation statements)

References 30 publications

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“…It appears that among all the screening tools, NRS 2002 and MUST have the strongest predictive value for mortality, and they are the easiest and quickest to calculate. A recent study [48] evaluated a higher cut off (>5) of NRS 2002. However, due to the lack of prospective validation of their utility for daily clinical practice and nutrition management, only expert opinion can be expressed.…”

Section: Statementmentioning

confidence: 99%

ESPEN guideline on clinical nutrition in the intensive care unit

et al. 2019

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s u m m a r yFollowing the new ESPEN Standard Operating Procedures, the previous guidelines to provide best medical nutritional therapy to critically ill patients have been updated. These guidelines define who are the patients at risk, how to assess nutritional status of an ICU patient, how to define the amount of energy to provide, the route to choose and how to adapt according to various clinical conditions. When to start and how to progress in the administration of adequate provision of nutrients is also described. The best determination of amount and nature of carbohydrates, fat and protein are suggested. Special attention is given to glutamine and omega-3 fatty acids. Particular conditions frequently observed in intensive care such as patients with dysphagia, frail patients, multiple trauma patients, abdominal surgery, sepsis, and obesity are discussed to guide the practitioner toward the best evidence based therapy. Monitoring of this nutritional therapy is discussed in a separate document.

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Section: Statementmentioning

confidence: 99%

ESPEN guideline on clinical nutrition in the intensive care unit

et al. 2019

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“…Ñõîaeå, ùî ñåðåä óñ³õ ³íñòðóìåíò³â ñêðèí³íãó, NRS 2002 ³ MUST ìàþòü íàéñèëüí³øå ïðîãíîñòè÷íå çíà÷åííÿ äëÿ ñìåðòíîñò³ òà º íàéïðîñò³øèìè òà íàéøâèäøèìè ó ðîçðàõóíêó. Ó íåäàâíüîìó äîñë³ä-aeåíí³ [48] [65][66][67][68][69][70][71]) íàø³ ðåçóëüòàòè ïîêàçàëè çíèaeåííÿ ³íôåêö³éíèõ óñêëàäíåíü ïðè ÅÕ (ÂÐ 0,50, Ä² 0,37, 0,67, ð = 0,005), à òàêîae ìåíøó òðè-âàë³ñòü ³íòåíñèâíî¿ òåðàï³¿ (ÂÐ -0,73, Ä² -1,30, -0,16, p = 0,01) òà ïåðåáóâàííÿ ó ñòàö³îíàð³ (ÂÐ -1,23, Ä² -2,02, -0,45, ð = 0,002; äèâ. Ðèñ.…”

Section: êîìåíòàðunclassified

Методичні Рекомендації ESPEN Щодо Клінічного Харчування У Відділенні Інтенсивної Терапії

Singer¹,

Blaser²,

Berger³

et al. 2019

Pain Anaesth Int Care

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“…Since both are not validated prospectively, at best only expert opinions are available for their use. 9 Going a step ahead, Mehta et al 1 recommended using computerized tomography or ultrasonography for the assessment of lean muscle mass in such patients. Utility of these two tools was reiterated by ESPEN 2018 guidelines.…”

Section: Nutrition Screening/assessment: Key Recommendations and Discmentioning

confidence: 99%

“…1 Patients with established EN and fair tolerance don't need GRV monitoring. 16 Springer et al (ESPEN 2018 guidelines) 9 recommended delaying EN feeding if GRV is >500 mL/6 hours. Canadian critical care systematic reviews 2018 17 also mention a threshold of 500 mL and state that there is no significant difference between GRV of 250 mL versus 500 mL on effecting infections, mortality, and ICU/hospital length of stay.…”

Section: Gastric Residual Volumes: Key Recommendations and Discrepanciesmentioning

confidence: 99%

Common Controversies in Critical Care Nutrition: Review of Latest Evidences

Joshi

Mehta

2019

J Card Crit Care

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Context Critical care nutrition favorably influences patient prognosis and remains an essential component of overall patient care. Various guidelines and literature discuss the modalities, benefits, and other finer details of nutrition in intensive care units. Critical care nutrition is still an emerging modality and hence, ambiguity/subjectivity exists in various aspects. Clear recommendations are not there, especially when it comes to diverse topics such as nutrition screening/assessment, underfeeding patients, types of nutrition formulae, monitoring nutrition adequacy, and tolerance and likewise. This article is an attempt to address couple of these concerns and review the latest evidences/guidelines in context of nutrition screening/assessment and monitoring tolerance by measuring gastric residual volumes (GRVs). Evidence Acquisition Various literature including existing guidelines, original articles, and review articles published till September 2019 and discussing the specifics of nutrition screening/assessment and monitoring tolerance by measuring gastric residuals were searched on popular scientific databases such as PubMed, Scholar Google, and Embase and reviewed for contextual relevance. Results Majority of the recommendations/evidences in this regard are either inconsistent or incomplete. Most of the tools that are recommended for nutrition screening/assessment of critical care patients are not validated for this population. Majority of literature is unanimous on not recommending biochemical parameters to be used for this purpose. Recommendations for the acceptable values of GRVs are consistent but subjectivity exits on the frequency of measurement, timing of measurement in relation to meals, and other variables. Conclusion Till the time, nutrition screening/assessment tools for critical care patients are validated in large multicentric settings, it would be prudent to adhere to the recommendations of existing guidelines. Similarly, GRV practices and cutoff values can be followed from relevant guidelines.

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Nutrition Risk in Critically Ill Versus the Nutritional Risk Screening 2002: Are They Comparable for Assessing Risk of Malnutrition in Critically Ill Patients?

Abstract: Our data suggest that NUTRIC is superior to NRS 2002 for assessing malnutrition risk in ICU patients. Randomized, controlled studies are needed to determine whether nutrition interventions, stratified by NUTRIC score, can improve patient outcomes.

Cited by 54 publications

References 30 publications

ESPEN guideline on clinical nutrition in the intensive care unit

ESPEN guideline on clinical nutrition in the intensive care unit

Методичні Рекомендації ESPEN Щодо Клінічного Харчування У Відділенні Інтенсивної Терапії

Common Controversies in Critical Care Nutrition: Review of Latest Evidences

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