• N I Lázaro-Martín, M Catalán-González, C García-Fuentes, L Terceros-Almanza, and J C Montejo-González.
• Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España. Electronic address: lazaronoelia@hotmail.com.
• Med Intensiva. 2015 Dec 1; 39 (9): 530-6.

ObjectivesTo analyze the nutritional management practices in Intensive Care (ICU) to detect the need for improvement actions. Re-evaluate the process after implementation of improvement actions.DesignProspective observational study in 3 phases: 1) observation; 2) analysis, proposal development and dissemination; 3) analysis of the implementation.SettingICU of a hospital of high complexity.ParticipantsAdult ICU forecast more than 48h of artificial nutrition.Primary EndpointsParenteral nutrition (PN), enteral nutrition (EN) (type, average effective volume, complications) and average nutritional ratio.ResultsA total of 229 patients (phase 1: 110, phase 3: 119). After analyzing the initial results, were proposed: increased use and precocity of EN, increased protein intake, nutritional monitoring effectiveness and increased supplementary indication NP. The measures were broadcast at specific meetings. During phase 3 more patients received EN (55.5 vs. 78.2%, P=.001), with no significant difference in the start time (1.66 vs. 2.33 days), duration (6.82 vs. 10,12 days) or complications (37,7 vs. 47,3%).Use of hyperproteic diets was higher in phase 3 (0 vs. 13.01%, P<.05). The use of NP was similar (48.2 vs. 48,7%) with a tendency to a later onset in phase 3 (1.25±1.25 vs. 2.45±3.22 days). There were no significant differences in the average nutritional ratio (0.56±0.28 vs. 0.61±0.27, P=.56).ConclusionsThe use of EN and the protein intake increased, without appreciating effects on other improvement measures. Other methods appear to be necessary for the proper implementation of improvement measures.Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

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