Associação entre adequação calórico-proteica e início precoce da terapia nutricional enteral com o desfecho clínico de pacientes oncológicos na unidade de terapia intensiva

Abstract

Introduction: Complications associated to cancer may contribute to the admission of oncological patients to the Intensive Care Unit (ICU) and it have association to worst prognosis. Critical patients usually need Enteral Nutrition Therapy (ENT). Early enteral nutrition and the caloric-protein adequacy have associations with good prognosis, reduction of hospitality, costs and mortality. Objective: Evaluate the association between caloric-protein adequacy of enteral nutrition therapy and early enteral nutrition therapy, with the clinical outcomes in oncological patients in the Intensive Care Unit. Methods: It is a cross sectional study with 114 oncological patients admitted to ICU, at a Cancer Center in Brazil between January to December 2017. The inclusion criteria were patients aged 18 years old and over, who received ENT during the length of stay in ICU for at least 72 hours. Data collection was performed based on medical records. Results: Sixty-four percent of patients have early enteral nutrition. Patients who did not have early enteral nutrition had significant statistic association with death in the ICU (p=0,031) and in the clinical outcomes final (p=0,015). Moreover, there was association between late start of enteral nutrition with longer ICU (p=0,001) and hospital stay (p=0,027). Patients who did not get energy (p=0,045) and protein (p=0,020) adequacies had longer length of stay in ICU. Conclusion: The early enteral nutrition has low association with death and with less total ICU and hospital stay. Early enteral nutrition was associated with less total ICU and hospital stay. To prove these results should take more studies, t hat might change the conduct of clinical practice.