중환자실 재원 환자의 영양지원 현황
Analysis of Nutritional Support Status in the Intensive Care Unit
2
조회
0
다운로드
14
인용
0
참고문헌
키워드
초록
Background: Nutritional support is important in intensive care for critically ill patients in an effort to decrease the mortality and morbidity. This study was conducted to evaluate the propriety of nutritional support and to understand the effect of a nutrition consultationin critically ill patients to assess and analyze nutritional status. Methods: Between January and December 2006, patients who were admitted to the intensive care unit (ICU)≥7 days and between 20 and 80 years of age were included. Patients transferred to another hospital, patients discharged against medicine advice, and patients with unknown weight were excluded. Two hundred sixty-two patients were enrolled. The demographic data of patients and the state of nutritional support were reviewed by medical records. Results: Two hundred sixty-two patients stayed in the ICU a mean of 16.0±9.8 days and received nutrition support for 11.0±8.4 days. Except 15 patients who did not receivenutritional support, the mean daily calculated caloric requirement of 247 patients was 1,406.2±253.8 kcal, the mean daily delivered caloric amount was 899.5±338.7 kcal, and the total delivered/required caloric ratio was 66.4±28.1%. The total delivered/required caloric ratio of the patients who received a nutritional consultation and the patients who did not receive nutritional consultation were 72.6±25.8% and 55.9±33.3%. Conclusions: In this study, we identified that critically ill patients received insufficient nutritional support. We recommend continuous monitoring and management for nutritional support by systematic administration of nutritional support teams.
Abstract
Background: Nutritional support is important in intensive care for critically ill patients in an effort to decrease the mortality and morbidity. This study was conducted to evaluate the propriety of nutritional support and to understand the effect of a nutrition consultationin critically ill patients to assess and analyze nutritional status. Methods: Between January and December 2006, patients who were admitted to the intensive care unit (ICU)≥7 days and between 20 and 80 years of age were included. Patients transferred to another hospital, patients discharged against medicine advice, and patients with unknown weight were excluded. Two hundred sixty-two patients were enrolled. The demographic data of patients and the state of nutritional support were reviewed by medical records. Results: Two hundred sixty-two patients stayed in the ICU a mean of 16.0±9.8 days and received nutrition support for 11.0±8.4 days. Except 15 patients who did not receivenutritional support, the mean daily calculated caloric requirement of 247 patients was 1,406.2±253.8 kcal, the mean daily delivered caloric amount was 899.5±338.7 kcal, and the total delivered/required caloric ratio was 66.4±28.1%. The total delivered/required caloric ratio of the patients who received a nutritional consultation and the patients who did not receive nutritional consultation were 72.6±25.8% and 55.9±33.3%. Conclusions: In this study, we identified that critically ill patients received insufficient nutritional support. We recommend continuous monitoring and management for nutritional support by systematic administration of nutritional support teams.
참고문헌 (21)
- Arora NS, "Respiratory muscle strength and maximal voluntary ventilation in undernourished patients", Am Rev Respir Dis, 126, pp.5~8 (1982)
- Windsor JA, "Risk factors for postoperative pneumonia. The importance of protein depletion", Ann Surg, 208, pp.209~214 (1988)
- Robinson G, "Impact of nutritional status on DRG length of stay", JPEN J Parenter Enteral Nutr, 11, pp.49~51 (1987)
- Appelboam R, "Nutrition in the critically ill patient", Anaesth Intensive Care Med, 7, pp.121~123 (2006)
- Kudsk KA, "Enteral versus parenteral feeding. Effects on septic morbidity after blunt and penetrating abdominal trauma", Ann Surg, 215, pp.503~511 (1992)
- McWhirter JP, "Incidence and recognition of malnutrition in hospital", BMJ, 308, pp.945~948 (1994)
- Giner M, "In 1995 a correlation between malnutrition and poor outcome in critically ill patients still exists", Nutrition, 12, pp.23~29 (1996)
- McClave SA, "Are patients fed appropriately according to their caloric requirements?", JPEN J Parenter Enteral Nutr, 22, pp.375~381 (1998)
- Chung HK, "Energy deficiency aggravates clinical outcomes of critically ill patients", Korean J Crit Care Med, 20, pp.49~53 (2005)
- Cerra FB, "Applied nutrition in ICU patients. A consensus statement of the American College of Chest Physicians", Chest, 111, pp.769~778 (1997)
- McClave SA, "Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.-P.E.N.)", JPEN, 33, pp.277~316 (2009)
- Singer P, "ESPEN Guidelines on Parenteral Nutrition: intensive care", Clin Nutr, 28, pp.387~400 (2009)
- Kim JH, "Clinical survey of patients in intensive care unit from March 1990 to February 1992 in Korea University Anam Hospital", Korean J Crit Care Med, 7, pp.121~130 (1992)
- Zaloga GP, "Early enteral nutritional support improves outcome: hypothesis or fact?", Crit Care Med, 27, pp.259~261 (1999)
- Marik PE, "Early enteral nutrition in acutely ill patients: a systematic review", Crit Care Med, 29, pp.2264~2270 (2001)
- Heyland DK, "Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients", JPEN J Parenter Enteral Nutr, 27, pp.355~373 (2003)
- Behara AS, "Nutrition support in the critically ill: a physician survey", JPEN J Parenter Enteral Nutr, 32, pp.113~119 (2008)
- De Jonghe B, "A prospective survey of nutritional support practices in intensive care unit patients: what is prescribed? What is delivered?", Crit Care Med, 29, pp.8~12 (2001)
- Reynolds N, "Nutrition support teams: an integral part of developing a gastroenterology service", Gut, 37, pp.740~742 (1995)
- Barr J, "Outcomes in critically ill patients before and after the implementation of an evidence-based nutritional management protocol", Chest, 125, pp.1446~1457 (2004)
- Mackenzie SL, "Implementation of a nutrition support protocol increases the proportion of mechanically ventilated reaching enteral nutrition targets in the adult intensive care unit", JPEN J Parenter Enteral Nutr, 29, pp.74~80 (2005)