Nutritional adequacy in critically ill patients: Result of PNSI study

Zeinab Javid, Mahdi Shadnoush, Majid Khadem-Rezaiyan, Niyaz Mohammad Zadeh Honarvar, Alireza Sedaghat, Seyed Mohammadreza Hashemian, Seyed Hossein Ardehali, Mohsen Nematy, Omid Pournik, Mohammad Taghi Beigmohammadi, Mohammad Safarian, Omid Moradi Moghaddam, Masoum Khoshfetrat, Farid Zand, Afshin Mohammad Alizadeh, Mahboube Kosari Monfared, Fatemeh Mazaheri Eftekhar, Maryam Mohamadi Narab, Arefe Sadat Taheri, Khatereh BabakhaniBehnam Foroutan, Tannaz Jamialahmadi, Bahareh Jabbarzadeh Gangeh, Mehrnoush Meshkani, Fahime Kimiaee, Abdolreza Norouzy*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background & aims: Critically ill patients are provided with the intensive care medicine to prevent further complications, including malnutrition, disease progression, and even death. This study was intended to assess nutritional support and its' efficacy in the Intensive Care Units (ICUs) of Iran.

Methods: This cross-sectional study assessed 50 ICU's patients out of 25 hospitals in the 10 major regions of Iran's health system and was performed using the multistage cluster sampling design. The data were collected from patient's medical records, ICU nursing sheets, patients or their relatives from 2017 to 2018. Nutritional status was investigated by modified NUTRIC score and food frequency checklist.

Results: This study included 1321 ICU patients with the mean age of 54.8 ± 19.97 years, mean mNUTRIC score of 3.4 ± 2.14, and malnutrition rate of 32.6%. The mean time of first feeding was the second day and most of patients (66%) received nutrition support, mainly through enteral (57.2%) or oral (37%) route during ICU stay. The patients received 59.2 ± 37.78 percent of required calorie and 55.5 ± 30.04 percent of required protein. Adequate intake of energy and protein was provided for 16.2% and 10.7% of the patients, respectively. The result of regression analysis showed that the odds ratio of mNUTRIC score was 0.85 (95% confidence interval [CI] = 0.74–0.98) and APACHE II was 0.92 (95%CI = 0.89–0.95) for the prediction of energy deficiency. Nutrition intake was significantly different from patient's nutritional requirements both in terms of energy (p < 0.001) and protein (p < 0.001). Also, mean mNUTRIC score varied notably (p = 0.011) with changing in energy intake, defined as underfeeding, adequate feeding, and overfeeding.

Conclusion: The present findings shown that, provided nutritional care for ICU patients is not adequate for their requirements and nutritional status.

Original languageEnglish
Pages (from-to)511-517
Number of pages7
JournalClinical Nutrition
Volume40
Issue number2
Early online date20 Jun 2020
DOIs
Publication statusPublished - Feb 2021

Bibliographical note

Publisher Copyright:
© 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism

Keywords

  • Energy intake
  • Intensive care unit
  • Nutritional support
  • Protein deficiency

ASJC Scopus subject areas

  • Nutrition and Dietetics
  • Critical Care and Intensive Care Medicine

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