IMPORTANCE OF NUTRITION ASSESSMENT IN CRITICALLY ILL PATIENTS

Authors

  • V. Suganya Madurai KamarajUniversity, Madurai, India
  • Vasantha Esther Rani Head of the Home Science Department, Fatima College, Madurai, India

DOI:

https://doi.org/10.18006/2021.9(Spl-1-GCSGD_2020).S55.S61

Keywords:

Intensive Care Unit, Subjective Global Assessment, Acute Physiology and Chronic Health Evaluation, Body Mass Index

Abstract

A timely assessment of nutritional status in critically ill patients is crucial. This was an observational prospective hospital study carried out for 3 months from December 2019 to February 2020 in an ICU in a multispecialty hospital in Madurai, Tamilnadu, India. All adult patients with ≥ 72 hours of ICU-LOS were included and their nutritional assessment was completed by SGA (Subjective Global Assessment) forms within 24 hours of ICU admission. Data collected regarding variables such as Age, Nutritional status, APACHE IV, SOFA score, presence of Comorbidities. All patients were studied about their duration of stay in ICU and hospital, Predicted Mortality rate, & discharge outcome.120 patients were involved in the study in the age 62. 2 ± 14.years, among this 55.3% were males and rest 44.7% were females. Their complete nutritional assessment revealed that 50%, 43%, and 17% were well nourished, moderately malnourished, severely malnourished respectively. A strong correlation was observed between nutritional status, morbidity, and their prolonged stay in ICU. Mean ICU & hospital mortality percentage was 37%, 45% respectively. The average duration of stay in the ICU and hospital was 13, 20 days respectively. Participants anthropometric data decreased considerably (mean weight, MUAC, calf circumference) during ICU discharge day. BMI comparison of admission and discharge didn’t show significant change. Timely nutrition intervention and medical nutrition therapy reduce the duration of patient stay in ICU and hospital and improved patient outcomes. The disease severity scoring system can be used as guidance for objective assessment of disease outcomes and estimation of the chance of recovery.

References

Bendavid I, Singer P, Thellia M (2017) Nutrition Day ICU: A 7 year worldwide prevalence study of nutrition practice in intensive care. Clinical Nutrition 36:1122-9.

Blaser AR, Starkop FJ, Alhazzani W (2017) Early enteral nutrition in critically ill patients: ESICM clinical practice guidelines. Intensive Care Medicine 43:380-98.

Chakravarty C, Hazarika B, Goswami L, Ramasubban S (2013) Prevalence of malnutrition in a tertiary care hospital in India. Indian Journal of Critical Care Medicine17:170-3.

Das A, Saimala G, Reddy N, Mishra P, Giri R, Kumar A, Raj A, Kumar G, Chaturvedi S, Babu S, Srikantiah S, Mahapatra T (2020) Mid-upper arm circumference as a substitute of the body mass index for assessment of nutritional status among adult andadolescent females: learning from an impoverished Indian state. Public Health 179: 68–75.

Haung YC, Yen CE, Cheng CH, JihksKan MN (2000) Nutritional status of mechanically ventilated critically ill patients: comparison of different types of nutritional support. Clinical Nutrition 19:101-107.

Herridge MS, Moss M, Hough CL, Hopkins RO, Rice TW, Bienvenu OJ, Azoulay E (2016) Recovery and outcomes after the acute respiratory distress syndrome (ARDS) in patients and their family caregivers. Intensive Care Medicine 42(5):725-38.

Heyland DK, Dhaliwal R, Jiang X, Day AG (2011) Identifying critically ill patients who benefit the most from nutrition therapy: The development and initial validation of a novel risk assessment tool. Critical Care 15:R268.

Hopkins RO, Suchyta MR, Kamdar BB, Darowski E, Jackson JC, Needham DM (2017) Instrumental activities of daily living after critical illness: a systematic review. The Annals of the American Thoracic Society 14(8):1332-43.

Lew CC, Yandell R, Fraser RJ, Chua AP, Chong MF, Miller M (2017) Association between malnutrition and clinical outcomes in the Intensive Care Unit: A Systematic review. JPEN Journal of Parenteral and Enteral Nutrition 41:744-58.

McClave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C (2016) Guidelines for the provision and

assessment of nutrition support therapy in the adult critically ill patient: Society of Critical care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN Journal of Parenteral Enteral Nutrition40:159-211.

Mehta Y, Sunavala JD, Zirpe K, Tyagi N, Garg S, Sinha S (2018) Practice guidelines for nutrition in critically ill patients: A relook for Indian scenario. Indian Journal of Critical Care Medicine 22:263-73.

Mendes R, Policarpo S, Fortuna P, Alves M, Virella D, Heyland DK (2017) Nutritional risk assessment and cultural validation of the modified NUTRIC score in critically ill patients-A multicenter prospective cohort study. Journal of Critical Care 37: 249.

Nicolo M, Heyland DK, Chittams J, Sammarco T, Compher C (2016) Clinical outcomes related to protein delivery in a critically ill population: a multicenter, multinational observation study. JPEN Journal of Parenteral and Enteral Nutrition 40(1):45–51.

Schiesser M, Kirchhoff P, Müller MK, Schäfer M, Clavien PA (2009) The correlation of nutrition risk index, nutrition risk score, and bioimpedance analysis with postoperative complications in patients undergoing gastrointestinal surgery. Surgery145: 519-526.

Simon Lambden, Pierre Francois Lattere, Mitchell M Levy, Bruno Francois (2019) The SOFA score - development, utility and challenges of accurate assessment in clinical trials. Critical care 23,Article number :374

Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP (2019) ESPEN guideline on clinical nutrition in the intensive care unit. Clinical Nutrition38(1):48-79.

Vallejo KP, Martinez CM, Adames AM (2017) Current clinical nutrition practices in critically ill patients in Latin America: a multinational observational study. Critical Care 21:227.

Wischmeyer PE (2017) Tailoring nutrition therapy to illness and recovery. Critical Care 21(3):316.

Nematy M, Mohajeri SAR, Moghadam SA, Safarian M, Norouzy A, Parizadeh SMR, et al. Nutritional status in intensive care unit patients: a prospective clinical cohort pilot study. Mediterranean Journal of Nutrition and Metabolism 5:163–8. doi: 10.1007/s12349-011-0071-x

Downloads

Published

2021-03-25

How to Cite

Suganya, V. ., & Rani, V. E. . (2021). IMPORTANCE OF NUTRITION ASSESSMENT IN CRITICALLY ILL PATIENTS. Journal of Experimental Biology and Agricultural Sciences, 9(Spl-1-GCSGD_2020), S55-S61. https://doi.org/10.18006/2021.9(Spl-1-GCSGD_2020).S55.S61