Adequação da Terapia Nutricional enteral em pacientes críticos de um Hospital Universitário

Abstract

Malnutrition in intensive care has been demonstrated in studies and inadequate nutrition is a determining factor for the complications and may contribute to the higher mortality. This study aimed to evaluate the adequacy of enteral nutrition therapy in critically ill patients admitted to the Intensive Care Unit of the Hospital Dr. Miguel Riet Correa Junior of the Federal University of Rio Grande - FURG and its association to the clinical evolution. Was included all patients who received enteral nutrition therapy for more than 72 hours between May and November 2014. Nutritional status was assessed by the Subjective Global Assessment on admission to the ICU and reapplied weekly. The energy and protein requirements were calculated using the recommendations for critical patients. Data were collected to patient's records. Energy and protein adequacy was determined by the ratio between administered and prescribed. Up to 70% of the prescribed was considered adequate. The adequacy was associated to the length of stay, duration of mechanical ventilation and mortality. 32 patients were included (mean age was 56.4 ± 17.4 years, 59.4% were man). Only 21 (65.6%) patients achieved up to 70% of calories requirement and 19 (59.4%) patients achieved up to 70% of protein requirement. The means of adequacy were 72.3% for calories, 70.2% for protein and 72.6% for diet volume. 213 interruptions of enteral nutrition were identified, 81.3% of patients had suspended diet due to break for procedures and tests, 56.3% had clinical worsening, 53.1% showed gastrointestinal symptoms, 50.0% had wrong administration in the enteral nutrition and 31.3% had problems with the enteral tube. There was no association between energy and protein intake with the length of stay, duration of mechanical ventilation and mortality in critically ill patients. More studies are needed to determine the value of caloric and protein adequacy, aimed at improving patient health in ICU and minimizing complications related to enteral nutrition.