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Multicenter Study
Nutritional support team intervention in surgical ICUs and its effect on nutrition delivery and quality in critically ill patients.
- Andrés Martinuzzi, Adriana Crivelli, Ariel Lopez, Darío Sgarzini, Virginia Aragon, Fátima Galeano, Maria Cristina Billinger, Mariana Doeyo, Milagros Matano, Paula Salomone, Dafne Cabrera, Ariana Del Fabro, and Ezequiel Manrique.
- Universidad Nacional de La Plata, Critical Care Specialist SATI-UBA (Argentine Society of Critical Care - University of Buenos Aires) and Nutritional Support Expert AANEP (Argentine Association of Enteral and Parenteral Nutrition), Neuquén, Argentina. Electronic address: andres.martinuzzi@nutrihome.com.ar.
- Nutrition. 2024 Sep 1; 125: 112501112501.
RationalCritically ill surgical patients pose one of the greatest challenges in achieving nutritional goals. Several published papers have demonstrated clear benefits when nutrition support (NS) is managed by a multidisciplinary nutrition support team (NST). We hypothesized that implementing a NST in a surgical intensive care unit (ICU) would increase the number of patients achieving their nutritional goals.Material And MethodMulticenter "BEFORE & AFTER" study. In the BEFORE phase, an audit of the previous state of NS was conducted in three ICUs without a NST.InterventionImplementation of a NST and protocol. In the AFTER phase, a new audit of NS was conducted. Continuous variables (presented as mean ± SD or median Q1-Q3) were tested using the t-test and Mann-Whitney U test. Categorical variables (presented as frequencies and percentages) were assessed using the chi-square test. A binomial logistic regression model was performed, with independent variables introduced using a stepwise forward method. A difference was considered to be significant with a two-sided P-value <0.05. Statistical analysis was conducted using IBM-SPSS 26.ResultsA total of 83 patients were included in the BEFORE phase, and 85 in the AFTER phase. The latter group showed a higher frequency of nutritional risk and malnutrition (SGA B+C odds ratio 2.314, 95% CI 1.164-4.600). Laparoscopy was more frequently utilized as a surgical technique in the AFTER phase. No differences were observed in ICU and hospital LOS or 90 days' survival rates. Two variables remained independent factors to predict NS achievement: NST implementation (odds ratio 3.582, 95% CI 1.733-7.404), and surgical technique (odds ratio 3.231, 95% CI 1.312-7.959).ConclusionNST positively impacts the chance of achieving NS goals in critically ill surgical patients.Copyright © 2024 Elsevier Inc. All rights reserved.
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