PhilSPEN Online Journal of Parenteral and Enteral Nutrition

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(Article 117 | POJ_0111)

Submitted Abstracts

PENSA 2017 Congress

Submitted: October 5, 2017

Abstract ID = 81 | Classification: (3) - Critical care and related issues

Title: Critical care nutrition update: does the nutrition team still achieve adequate intake with good outcomes?

Author(s): Precy Gem Calamba MD and Luisito Llido MD

Institution where study was conducted: Clinical Nutrition Service, St. Luke’s Medical Center (SLMC), Quezon City, Philippines

Keywords: critical care, nutrition, team, outcome, mortality, calorie, protein

Background: Adequate intake is associated with improved mortality and morbidity outcomes in critical care patients and the presence of a nutrition team sustains these results. The Clinical Nutrition Service of SLMC was organized for this purpose with the team working to achieve adequate nutrient intake, calories and protein.

Objectives: a) To show the profile of critical care patients and b) To determine if the nutrition team is able to achieve adequate calories and protein with reduction of mortality in the critical care patients

Methods: Age and sex profile was documented; calorie and protein intake were recorded and adequacy determined. Adequacy was pegged at 70% of calculated calorie or protein requirements. Mortality was correlated with nutrition risk scores and nutrient intake.

Results: N = 210; Patient profile: mean age: 67.6 (42.6) years; male to female ratio is 1:1. SGA “C” = 100/108 (93%); nutrition risk score > 5 = 18/34 (53%), nutrition risk score < 5 = 16/34 (47%). Calorie intake profile: mean calorie requirement/day = 1596 kcal; mean calorie intake/day = 1255 kcal/day; patients with positive calorie balance: 144/182 (79%), patients with negative calorie balance: 38/182 (20%). Protein intake profile: mean protein requirement/day = 75.9 gm/day; mean protein intake/day = 54.25 gm/day; patients with positive protein balance: 156/182 (86%), patients with negative protein balance: 26/182 (14%). Clinical outcome profile: mean ICU days = 6.5 (3.29); mortality rate = 5/34 (15%), mortality rate for patients with nutrition risk score < 5 = 0/16 (0%), mortality for patients with nutrition risk score > 5 = 5/16 (31%), mortality rate in patients with inadequate calories or protein (< 70% of calculated) = 2/5 (40%).

Conclusion: The Clinical Nutrition Service team was able to achieve adequate nutrient intake in 79%-86% of critical care patients. Mortality rate was 15% overall with 31% among those with nutrition risk score > 5 and 40% among those with inadequate nutrient intake (calorie or protein).