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The impact of nutritional support on morbimortality of critically ill patients

Introduction

Although the benefits of nutritional support have been demonstrated in cellular and animal studies, the effects on patient morbidity and mortality have been less evident.

Objective

This study analyzes the influence of nutritional support on morbidity and mortality of critically ill patients.

Methods

Included in the study were all patients admitted to a 13-bed general intensive care unit (ICU) in the period from 1 June 2000 to 31 July 2001 who remained in the ICU for at least 7 days and who received at least 4 days of nutritional support (parenteral or enteral). Patients were classified into two groups according to calories received in the study period (7–10 days after admission): group A, patients who received at least 70% of their resting energy expenditure; and group B, patients who received less than 70%. Patients were also classified according to calories received on the third ICU day: group C, those patients who on the third day received 70% or more of the resting energy expenditure; and group D, those patients receiving less than 70%. We analyzed the length of stay in the ICU, mortality, incidence of nosocomial pneumonia and other infectious complications.

Results

In the study period, 612 patients were admitted to the ICU. Ninety were included in the study, 37 patients in group A and 53 in group B. There was no difference between the two groups with respect to mortality (relative risk [RR] = 1.21; 95% confidence interval [CI], 0.70–2.07; P = 0.40), nosocomial pneumonia (RR = 1.22, 95% CI, 0.74–2.01; P = 0.44) and other infectious complications (RR = 0.99; 95% CI, 0.60–1.62). On the other hand, analysis of group C and group D showed a tendency for reduced mortality (RR = 1.74; 95% CI, 0.69–4.39) and other infectious complications (RR = 0.58; 95% CI, 0.25–1.34) in group C.

Conclusion

In this study, as in many other published studies, it was not possible to demonstrate that nutritional support has a positive influence on morbidity and mortality of critically ill patients. However, the observed tendency to a lower morbimortality in those patients that received adequate nutrition on the third ICU day is consistent with findings in other studies.

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Azevedo, J., Cruz, K. The impact of nutritional support on morbimortality of critically ill patients. Crit Care 7, P99 (2003). https://doi.org/10.1186/cc2295

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Keywords

  • Public Health
  • Confidence Interval
  • Intensive Care Unit
  • Energy Expenditure
  • Pneumonia