Journal of Medical and Surgical Intensive Care Medicine 2016 , Vol 7, Issue 1
Factors Associated with Insufficient Nutrition and Effects of Timely Adequate Nutrition Support on Patient Outcomes in Intubated Adult Intensive Care Unit Patients
Yusuf Savran 1 , Murat Emre Tokur 1 , Bilgin Cömert 1 , Muhammet Limon 2
1Dokuz Eylül Üniversitesi Tıp Fakültesi, Dahiliye Yoğun Bakım Servisi, İzmir, Türkiye
2Dokuz Eylül Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, İzmir, Türkiye
DOI : 10.5152/dcbybd.2016.891

Objective: Our primary aim was to evaluate the relationship between adequate nutrition support and infectious complications, length of stay in the intensive care unit (ICU) and hospital, and rate of mortality in critically ill patients. Our secondary aim was to evaluate the causes of insufficient nutrition in patients.

Material and Methods: This retrospective study was performed in a medical ICU between January 2012 and December 2013. Patients who older than 18 years and who were on mechanical ventilator (Hamilton Medical, Rhazuns, Switzerland) support for at least 3 days were included.

Results: In total, 220 patients were included, 133 (60.4%) of whom were males. The mean age of the patients was 70.3 years. One hundred fifty-one patients were found to reach the target caloric intake. Enteral nutrition (EN) was the major route in patients who reached the target calorie intake (p<0.001). The most common cause for the cessation of EN was the detection of residue. Parenteral nutrition (PN) and lymphoma were major independent risk factors for inadequate calorie intake. A high Acute Physiology and Chronic Health Evaluation II score (p<0.001), PN (p<0.001), immunosuppressive treatment (p=0.005), and existence of solid tumors (p=0.006) were identified as independent risk factors for mortality. The mortality rates of patients in groups of adequate and insufficient calorie intake were 53% and 76%, respectively (p=0.001).

Conclusion: EN is more effective in reaching the target calorie delivery. More efforts should be made to continue EN. Adequate nutrition significantly decreases the mortality rate. 

Keywords : Enteral nutrition, parenteral nutrition, critically ill, intensive care, mortality, calorie intake