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Nutritional support for critically ill patients: Does duration correlate with mortality?
MedLine Citation:
PMID:  21376522     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Few investigations have correlated long-term nutritional support (NS) with outcome in the intensive care unit, in comparison with NS for shorter periods. OBJECTIVE: In a retrospective protocol, duration of enteral and/or parenteral nutrition was analyzed in the light of severity of illness, targeting hospital mortality. RESULTS: Seriously ill patients (n = 100), nearly all (94/100) receiving enteral nutrition (51/100), parenteral nutrition (22/100), or both (21/100), were investigated. Mean age ± SD was 60.0 ± 19.5 years (54.0% males), 56.0% were in the trauma or surgery diagnostic category, Mean Acute Physiologic and Chronic Health Evaluation II ± SD was 14.2 ± 6.7, mechanical ventilation was necessary in 41.0%, and hospital mortality was 14.0%. Nutritional support of any modality administered for 18 days or less (mean ± SD, 4.3 ± 3.6 days) was associated with favorable survival rate, whereas for longer periods (mean ± SD, 48.5 ± 29.4 days), mortality substantially increased (7.7% vs 50.0%, P = .004). Results were confirmed when long-term patients were propensity matched regarding age, Acute Physiologic and Chronic Health Evaluation II, Glasgow scale, and mechanical ventilation (6.3% vs 50.0%, P = 04). CONCLUSIONS: Nutritional support of more than 18 days was associated with higher mortality. This finding persisted after adjustment for major risk factors, in agreement with the hypothesis that prolonged impossibility of oral alimentation is a marker of mortality in the intensive care unit setting.
Authors:
Alvaro A C Morais; Joel Faintuch; Eliana B Caser; Daniel S Costa; Bruno A Pazolini; Ary C Oliveira
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-2
Journal Detail:
Title:  Journal of critical care     Volume:  -     ISSN:  1557-8615     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610642     Medline TA:  J Crit Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Nutritional Support Service, EMESCAM Medical School, Vitoria, ES, Brazil.
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