The quality of nutrition at an intensive care unit

The quality of nutrition at an intensive care unit

Adequate nutrition of patients remaining at an intensive care unit (ICU) is of great importance since both over- and undernutrition can lead to serious morbidity and even mortality. The aim of our study was to examine whether patients at an ICU are adequately fed. A prospective follow-up was perform...

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Bibliographic Details
Published in:Nutrition research (New York, N.Y.) Vol. 22; no. 4; pp. 411 - 422
Main Authors: Jansen, M.M.P.M, Heymer, F, Leusink, J.A, de Boer, A
Format: Journal Article
Language:English
Published: New York, NY Elsevier Inc 2002
Elsevier Science
Subjects:
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
calorimetry
carbohydrates
correlation
Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition
energy expenditure
Energy needs
females
General aspects
Harris-Benedict formula
Indirect calorimetric measurement
Intensive care medicine
Intensive care unit
malnutrition
Medical sciences
morbidity
mortality
nitrogen
nutrition
nutritive value
patients
proteins
Public health. Hygiene
Public health. Hygiene-occupational medicine
Quality insurance (general aspects)
Quality of nutrition
Energy needs
Intensive care unit
Harris-Benedict formula
Quality of nutrition
Indirect calorimetric measurement
Human
Energetic value
Nutrition
Nutrient solution
Quality
Chemical composition
Hospital
Macronutrient
Resuscitation
Public health
Feeding
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Summary:Adequate nutrition of patients remaining at an intensive care unit (ICU) is of great importance since both over- and undernutrition can lead to serious morbidity and even mortality. The aim of our study was to examine whether patients at an ICU are adequately fed. A prospective follow-up was performed in 39 surgical and medical mechanically ventilated patients who were at least two days on the ICU prior to inclusion. The mean age of the patients was 65 years (range 23 to 88) and 40% was female. For each patient the following data were collected. First, the exact amounts of macronutrients (carbohydrates, fat and proteins) given over 24 hours by parenteral and/or enteral route were calculated (‘administered’). Second, on the same day indirect calorimetric measurement (DeltatrecTM II metabolic monitor) was performed over 18 hours and urinary nitrogen loss was measured over 24 hours in order to estimate energy expenditure and macronutrient usage (‘measured’). Third, by means of formulas developed by Harris Benedict and Long we calculated the needs for energy and macronutrients based on the clinical information obtained on the day prior to the day the indirect calorimetric measurements were performed (‘calculated’). In 10 patients (26%) the administered amount of energy was lower than the measured amount. In 16 patients (41%) the protein balance was negative. Four of the patients (10%) received more than 1500 kcal above the measured amount. In 11 patients (28%) the calculated amount of energy was lower than the measured energy expenditure. Coefficients of correlation between measured versus administered, calculated versus administered and measured versus calculated amounts of energy were 0.19 (p = 0.25), 0.03 (p = 0.87) and 0.57 (p = 0.0002), respectively. In conclusion, a substantial part of patients at an intensive care unit are not adequately fed. Some improvement of the quality of feeding can be established by using the Harris-Benedict formula in the prescribing of nutrition; measurement of the caloric and protein needs is the preferred method to adequately feed ICU patients.
Bibliography:http://www.nrjournal.com/issues?issue_key=S0271-5317(00)X0083-8
ISSN:0271-5317
1879-0739
DOI:10.1016/S0271-5317(01)00396-7