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Analysis of the nutritional management practices in intensive care: Identification of needs for improvement.

Abstract：

OBJECTIVES:To 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. DESIGN:Prospective observational study in 3 phases: 1) observation; 2) analysis, proposal development and dissemination; 3) analysis of the implementation. SETTING:ICU of a hospital of high complexity. PARTICIPANTS:Adult ICU forecast more than 48h of artificial nutrition. PRIMARY ENDPOINTS:Parenteral nutrition (PN), enteral nutrition (EN) (type, average effective volume, complications) and average nutritional ratio. RESULTS:A 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). CONCLUSIONS:The 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.

journal_name

Med Intensiva

journal_title

Medicina intensiva

authors

Lázaro-Martín NI,Catalán-González M,García-Fuentes C,Terceros-Almanza L,Montejo-González JC

doi

10.1016/j.medin.2015.04.010

subject

Has Abstract

pub_date

2015-12-01 00:00:00

pages

530-6

issue

9

eissn

0210-5691

issn

1578-6749

pii

S0210-5691(15)00109-6

journal_volume

39

pub_type

杂志文章

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