Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool
TLDR
This scoring algorithm may be helpful in identifying critically ill patients most likely to benefit from aggressive nutrition therapy in the intensive care unit (ICU), and based on the statistical significance in the multivariable model, the final score used all candidate variables except BMI.Abstract:
To develop a scoring method for quantifying nutrition risk in the intensive care unit (ICU). A prospective, observational study of patients expected to stay > 24 hours. We collected data for key variables considered for inclusion in the score which included: age, baseline APACHE II, baseline SOFA score, number of comorbidities, days from hospital admission to ICU admission, Body Mass Index (BMI) < 20, estimated % oral intake in the week prior, weight loss in the last 3 months and serum interleukin-6 (IL-6), procalcitonin (PCT), and C-reactive protein (CRP) levels. Approximate quintiles of each variable were assigned points based on the strength of their association with 28 day mortality. A total of 597 patients were enrolled in this study. Based on the statistical significance in the multivariable model, the final score used all candidate variables except BMI, CRP, PCT, estimated percentage oral intake and weight loss. As the score increased, so did mortality rate and duration of mechanical ventilation. Logistic regression demonstrated that nutritional adequacy modifies the association between the score and 28 day mortality (p = 0.01). This scoring algorithm may be helpful in identifying critically ill patients most likely to benefit from aggressive nutrition therapy.read more
Citations
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Design of nutrition trials in critically ill patients: food for thought
TL;DR: The authors would like to thank Drs.
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Utilization of Intensive Care Unit Nutrition Consultation Is Associated With Reduced Mortality.
Christopher J. Tignanelli,Kyle H. Sheetz,Ashley Petersen,Pauline K. Park,Lena M. Napolitano,Colin R. Cooke,Jill R. Cherry-Bukowiec +6 more
TL;DR: It is suggested that increased utilization of NC in critically ill patients may be associated with improved clinical outcomes, and rates of NC were low in critical ill patients.
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Comparison of resting energy expenditure measured with metabolic cart and calculated with predictive formulas in critically ill patients on mechanical ventilation
TL;DR: In this paper , the Harris-Benedict equation was used to estimate the resting energy expenditure (REE) of 27 ventilated ICU patients during breathing 40% and 60% inspired fractions of oxygen (FiO2).
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Effect of a nutritional support protocol on enteral nutrition and clinical outcomes of critically ill patients: a retrospective cohort study
TL;DR: The NICE-NST may improve EN supply and mortality of critically ill patients without increasing complications and showed that early EN through protocolized nutritional support would supply more nutrition to improve clinical outcomes.
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Seven Deadly Sins of Nutrition Therapy in Critically Ill Patients.
Sergio Henrique Loss,Oellen Stuani Franzosi,Diego Silva Leite Nunes,Cassiano Teixeira,Luciana Verçoza Viana +4 more
TL;DR: 7 nutrition steps that, if not followed by the clinical staff, may be metaphorically considered as "7 deadly sins" of nutrition therapy and are suggested as a mnemonic device for nutrition standard care in the intensive care unit.
References
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