Relationship between the NUTRIC nutritional risk scale and protein hypercatabolism in critically ventilated patients

Abstract

the Nutrition Risk in Critically Ill (NUTRIC) score does not include a variable that objectively estimates protein hypercatabolism (PHC), one of the main metabolic changes experienced by critical patients. to evaluate the correlation of the NUTRIC score with PHC in critically ventilated patients. prospective, observational study. Mixed ICU. It included ventilated patients ≥ 18 years old, without anuria or chronic renal failure. The modified NUTRIC score, which replaces IL-6 for PCR, was obtained at admission and 24-hour urine was collected at the 2nd (T0) and 4th day (T1) to determine the total urinary nitrogen (TUN). a total of 69 patients were included. Average age: 43 years (± 17.01); 73% were males. Admission pathologies: trauma (39%) and sepsis (20%). 17 (± 6.66). Seventeen patients presented acute renal failure (ARF). NUTRIC score mean: 3.13 (± 1.94); 84% presented low nutritional risk. The Pearson correlation between NUTRIC and TUN in T0 and T1 was: -0.150 (p: 0.218) and -0.053 (p: 0.663). The mean length of staying in ICU and mechanical ventilation was: 13.35 (± 12.37) and 9.84 (± 10.82) days, respectively. Mortality in ICU: 36%. In the non-ARF subgroup with low risk according to NUTRIC score, 27% presented severe PHC at T0 and 52% at T1. The correlation was: 0.070 (p: 0.620) and 0.138 (p: 0.329), respectively. no correlation was found between the estimators of the stress metabolic response of the NUTRIC score and the PHC in critically ill patients ventilated; therefore, it would not be possible to substitute the measurement of the same in the assessment of the nutritional risk.