Publications (2)2.24 Total impact
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Article: [Nutritional support response in critically ill patients: differences between medical and surgical patients].
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ABSTRACT: Objective: To assess the nutritional response of a group of critically ill patients, as well as the differences in the response to nutritional support between medical and surgical patients. Methods: One-year long retrospective study including critically ill patients on artificial nutrition for 7 days. Throughout the first week, three nutritional biochemical controls were done that included albumin, prealbumin, transferrin, cholesterol, and electrolytes. Other data gathered were: nutritional risk index, age, gender, weight, height, APACHE, delay of onset of nutritional support, access route, predicted and real caloric intake, medical or surgical patient, hospital stay, duration of the central venous catheter, urinary tube, and/or mechanical ventilation, incidence and density of incidence of nosocomial infections. Results: Sixty-three patients were studied, 30 (47%) medical and 33 (53%) surgical/trauma patients, with a usage of EN higher among medical patients (16/30, 53% vs. 5/33, 15%), PN higher among surgical patients (25/33, 76%), and mixed nutrition similar in both groups (5 medical and 3 surgical patients) (p = 0.001). There were no differences between medical and surgical patients regarding: both predicted and real caloric and nitrogenous intake, APACHE, delay of onset of nutrition, phosphorus, magnesium or glucose levels, mortality and incidence of nosocomial infections. There were no differences either in hospital stay or use of mechanical ventilation, although these tended to be lower in surgical patients. The baseline biochemical parameters did not show differences between both groups, although they were worse among surgical patients. These patients presented during the study period steady albumin levels with improvement in the remaining parameters, whereas medical patients showed a decrease in albumin and transferrin levels, steady prealbumin levels, and slightly improvement in cholesterol levels. Conclusions: We have observed higher usage of PN among surgical patients, which showed worse baseline nutritional biochemical parameters and responded better to nutritional support and having a trend towards shorter hospital stay and lower mechanical ventilation use than medical patients. We have not observed differences regarding the mortality or nosocomial infection.Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 08/2012; 27(4):1213-8. · 1.12 Impact Factor -
Article: [Nutritional support outcomes in critical care].
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ABSTRACT: To revise the effect of our nutritional support practices on outcomes from critical care patients and propose new study hypothesis. Retrospective observational study was conducted in all critically ill patients who had been prescribed nutritional support, through a year time, in an Intensive Care Unit. The nutritional support practices are described. Severity of illness (Simplified Acute Physiology Score II), timing and route of nutritional support, prescribed and delivered daily caloric intake for a maximum of 7 days, medical or surgical patient, length of stay in ICU, incidence rate and incidence density of nosocomial infections, and presence of gastrointestinal complications were recorded. Relationships between timing and route of nutritional support and percentage of received/ prescribed calories with mortality, nosocomial infections, days of mechanical ventilation and length of stay in the Intensive Care Unit were studied. 102 patients of our intensive care patients received nutritional support and were selected for the study. EN was used in 42 patients (41%), 41 (40%) received TPN and 19 patients (19%) received mixed nutrition. Timing of nutritional support showed a mean of 3.1 ± 1.9 days and was statistically different between patients who survived or died (2.82 ± 1.65 vs. 3.74 ± 2.33 days). Patients received 58 ± 28% of their requirements but this data did not show any difference with mortality and morbidity. There was a statistical difference between the route of nutrition and the following data: type of patient, caloric intake in the study period, length of stay in ICU and days of mechanical ventilation. Our study demonstrates that nutritional support patients are more severely ill than nonnutritional support patients. Timing of nutritional support was shorter in survivors. Our study confirms a low caloric input in the critically ill patient during the first week of illness, especially in the enteral nutrition group. However this finding was not associated with mortality or morbidity. Parenteral route did show better clinical outcomes than enteral or mixed nutrition. Our findings suggest that a moderate and early caloric intake could obtain better outcomes, independently of the route of nutritional support.Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 12/2011; 26(6):1469-77. · 1.12 Impact Factor
