Nutrition deficit during intensive care stay: incidence, predisposing factors and outcomes.

Abstract

Adequate nutrition support during intensive care has several benefits including lower amount of infectious complications, improved wound healing, shorter length of stay (LOS) and decreased morbidity. The aim of the present study was to survey the adequacy of nutrition throughout Intensive Care Unit (ICU) stay and to examine various factors associated to cumulative nutrition inadequacy during ICU stay. The study was a retrospective single center cohort study. The study population consisted of 1771 ICU adult (≥18 years) patients with emergency admission to ICU who had LOS between three and 40 days. Nutrition adequacy and factors associated to inadequate nutrition support during ICU stay were analyzed. Factors related to impaired energy balance were prescribed energy less than 25kcal/kg (OR 11.794 (9.017-15.427), P<0.001) and higher median CRP (OR 1.003 (1.001-1.004), P<0.001). Factors related to improved energy balance were length of stay (OR 0.975 (0.953-0.997), P=0.024), more than 30% Bolus enteral nutrition days (OR 0.314 (0.187-0.526), P<0.001) and Enteral/Parenteral -Ratio (OR 0.970 (0.953-0.987), P=0.001). The majority of ICU patients did not reach 60% of nutrition adequacy. Nutrition inadequacy was a common finding throughout the study population. Nutrition inadequacy might be partially avoidable since adequacy less than 60% was related to underprescription and failure to administer the prescribed nutrition. Bolus enteral nutrition might be an efficient method to deliver energy in ICU setting.