PhilSPEN Online Journal of Parenteral and Enteral Nutrition

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(Article 109 | POJ_0103)

Submitted Abstracts

PENSA 2017 Congress

Submitted: September 4, 2017

Abstract ID = 73 | Classification: (3) - Critical care and related issues

Title: A preliminary study on the nutritional intake among patients admitted at the medical intensive care unit and its relationship with clinical outcomes

Author(s): Blanco-Estabillo, AC; Albay, AB Jr.

Institution where study was conducted: Philippine General Hospital, Philippine General Hospital, Metro-Manila, Philippines

Keywords: Nutrition, intensive care unit, hospital acquired pneumonia, mortality

Background: Malnutrition is a prevalent problem in the intensive care unit. Despite several studies showing improvement in clinical outcomes with adequate and aptly timed delivery of nutritional support there is still suboptimal delivery of proper nutrition. Factors that lead to inadequate nutrition commonly includes frequent feeding interruptions, physician under prescription, gastrointestinal complications and problems related to feeding access.

Objectives: The objective of the study was to compare the actual and recommended total caloric intake of medical ICU patients and determine the relationship between the adequacy of intake and clinical outcomes.

Methods: Thirty-six patients admitted at the medical intensive care unit were enrolled in the study. Charts were reviewed daily for prescribed caloric intake, interruptions of feeding and its duration and reason. Actual caloric intake was recorded daily. The patients were followed up until they were discharged from the ICU or expired. Paired t-test was used to compare actual caloric intake and total caloric requirement. Binary regression, simple and multiple regressions were used to determine relationship between adequacy of caloric intake, total duration of feeding interruptions and clinical outcomes.

Results: Actual caloric intake in relation to recommended total caloric intake was inadequate in 23 patients (63.89%) included in the study (p-value = 0.003). The inadequate actual caloric intake in comparison with the total caloric requirement in combination with longer duration of feeding interruptions showed that there are increased rates of hospital acquired pneumonia (p-value = 0.012), prolonged duration of mechanical ventilation (p-value 0.001), longer ICU stay (p-value 0.003) and higher mortality rates (p-value 0.001).

Conclusion: There is inadequate actual caloric intake as compared with the total caloric requirement in patients admitted at the medical ICU. Inadequate caloric intake and prolonged duration of feeding interruptions resulted to poorer clinical outcomes.