Article Text

PDF
CP-038 Adequacy of nutrition energy delivery in surgical intensive care
  1. C Jolly1,
  2. F Raffy1,
  3. G Audibert2,
  4. J Perrier2,
  5. D Quilliot3
  1. 1Chu Nancy, Pharmacy, Nancy, France
  2. 2Chu Nancy, Surgical Intensive Care Unit, Nancy, France
  3. 3Chu Nancy, Nutrition Unit, Nancy, France

Abstract

Background Underfeeding is correlated with a higher morbidity rate, mortality and lenght of stay. Measuring and managinig nutrional risk are therefore important tasks.

Purpose Evaluation of nutrition adequacy energy delivery in surgical intensive care unit (ICU), compliant with European recommendations.

Material and methods Prospective study, of one month, in 3 surgical ICU with daily analysis of all nutritional supports. Were taken into account:oral alimentation and enrichment, enteral and parenteral nutrition, micronutrients and electrolytes supplies, energy delivery data and adequacy of nutritional support, duration, indication, weight loss. Energy targets were set at 15 kcal/kg/day for Day 3 (D3) and 20 kcal/kg/day for D7. Kruskal Wallis and Fischer tests were used for values of p < 0.05 considered significant ones.

Results Sixty six patients: mean age 57.9 ± 17.3 years and mean BMI 26.9 ± 5.2 kg/m2. Mean of length of stay was 10.1 ± 5.3 days (p > 0.05). Nutrition was initiated with parenteral nutrition for 39.4% patients versus 37.9% with enteral nutrition versus 22.7% with oral nutrition (p < 0.01). Time to feeding was 2.2 ± 1.1 days (p > 0.05). Energy target was reached at D3 for 53% patients vs 62% at D7 (p > 0.05). Time needed to achieve the target rate was 5.3 ± 2.9 days (p > 0.05). Energy delivery was lower than the energy target during the first 3 days (p < 0.001). Difference between energy target and delivery decreased from −19.7 kcal/kg/day as a mean during the first day, to a mean of −3.3 kcal/kg/day at D7. Proportion of energy target provided by the enteral, parenteral or oral route was not significantly different from D1 to D7 (p > 0.05). Cumulated energy balance was 5023 ± 38.9 kcal/kg/day. At the last day, protein intake was <1.2 g/kg/day for 32% of patients receiving parenteral nutrition vs. 38.5% receiving enteral nutrition (p < 0.05).

Conclusion One can reach the caloric target at D3 and D7 and provide a better balance between enteral and parental nutrition as defined by European recommendations.

References and/or Acknowledgements

  1. ESPEN guidelines 2006/2009

References and/or AcknowledgementsNo conflict of interest.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.