scholarly journals IMPORTANCE OF NUTRITION ASSESSMENT IN CRITICALLY ILL PATIENTS

2021 ◽  
Vol 9 (Spl-1- GCSGD_2020) ◽  
pp. S55-S61
Author(s):  
V. Suganya ◽  
◽  
Vasantha Esther Rani ◽  
Keyword(s):  
Nutritional Status ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Nutritional Assessment ◽  
Objective Assessment ◽  
Nutrition Therapy ◽  
Nutrition Intervention ◽  
Prolonged Stay ◽  
Duration Of Stay ◽  
Icu Discharge

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.

Nutritional status plays a crucial role in the mortality of critically ill patients with acute renal failure

2017 ◽  
Vol 66 (2) ◽  
pp. 309-318 ◽  
Author(s):  
Haiyan Zhang ◽  
Xiaodong Zhang ◽  
Lei Dong
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Intensive Care ◽  
Nutritional Status ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Medical Information ◽  
Statistical Significance ◽  
Nutrition Intervention ◽  
Icu Discharge

We aimed to clarify associations between nutritional status and mortality in patients with acute renal failure. De-identified data were obtained from the Medical Information Mart for Intensive Care III database comprising more than 40,000 critical care patients treated at Beth Israel Deaconess Medical Centerbetween 2001 and 2012. Weight loss and body mass index criteria were used to define malnutrition. Data of 193 critically ill patients with acute renal failure were analyzed, including demographics, nutrition intervention, laboratory results, and disease severity. Main outcomes were in-hospital and 1-year mortality. The 1-year mortality was significantly higher in those with malnutrition than in those without malnutrition (50.0% vs 29.3%, p=0.010), but differences in in-hospital survival were not significant (p=0.255). Significant differences in mortality were found between those with malnutrition and without starting at the 52nd day after intensive care unit (ICU) discharge (p=0.036). No significant differences were found between men and women with malnutrition in in-hospital mortality (p=0.949) and 1-year mortality (p=0.051). Male patients requiring intervention with blood products/colloid supplements had greater risk of 1-year mortality, but without statistical significance. Nutritional status is a predictive factor for mortality among critically ill patients with acute renal failure, particularly 1-year mortality after ICU discharge.

scholarly journals Impact of treating iron deficiency, diagnosed according to hepcidin quantification, on outcomes after a prolonged ICU stay compared to standard care: a multicenter, randomized, single-blinded trial

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Sigismond Lasocki ◽  
◽  
Pierre Asfar ◽  
Samir Jaber ◽  
Martine Ferrandiere ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Critically Ill ◽  
Primary Endpoint ◽  
Critically Ill Patients ◽  
Standard Care ◽  
Intravenous Iron ◽  
Prolonged Stay ◽  
Icu Stay ◽  
Icu Discharge ◽  
Prolonged Icu Stay

Abstract Background Anemia is a significant problem in patients on ICU. Its commonest cause, iron deficiency (ID), is difficult to diagnose in the context of inflammation. Hepcidin is a new marker of ID. We aimed to assess whether hepcidin levels would accurately guide treatment of ID in critically ill anemic patients after a prolonged ICU stay and affect the post-ICU outcomes. Methods In a controlled, single-blinded, multicenter study, anemic (WHO definition) critically ill patients with an ICU stay ≥ 5 days were randomized when discharge was expected to either intervention by hepcidin treatment protocol or control. In the intervention arm, patients were treated with intravenous iron (1 g of ferric carboxymaltose) when hepcidin was < 20 μg/l and with intravenous iron and erythropoietin for 20 ≤ hepcidin < 41 μg/l. Control patients were treated according to standard care (hepcidin quantification remained blinded). Primary endpoint was the number of days spent in hospital 90 days after ICU discharge (post-ICU LOS). Secondary endpoints were day 15 anemia, day 30 fatigue, day 90 mortality and 1-year survival. Results Of 405 randomized patients, 399 were analyzed (201 in intervention and 198 in control arm). A total of 220 patients (55%) had ID at discharge (i.e., a hepcidin < 41 μg/l). Primary endpoint was not different (medians (IQR) post-ICU LOS 33(13;90) vs. 33(11;90) days for intervention and control, respectively, median difference − 1(− 3;1) days, p = 0.78). D90 mortality was significantly lower in intervention arm (16(8%) vs 33(16.6%) deaths, absolute risk difference − 8.7 (− 15.1 to − 2.3)%, p = 0.008, OR 95% IC, 0.46, 0.22–0.94, p = 0.035), and one-year survival was improved (p = 0.04). Conclusion Treatment of ID diagnosed according to hepcidin levels did not reduce the post-ICU LOS, but was associated with a significant reduction in D90 mortality and with improved 1-year survival in critically ill patients about to be discharged after a prolonged stay. Trial registration www.clinicaltrial.gov NCT02276690 (October 28, 2014; retrospectively registered)

scholarly journals Nutritional Support To Critically Ill Patients - A Comparative Study Between Branded and Homemade Preparations

2009 ◽  
Vol 20 (1) ◽  
pp. 18-23
Author(s):  
Kazi Ashkar Lateef ◽  
Abdullah Al Maruf ◽  
Iqbal Hossain Chowdhury ◽  
Sayeed Mahmud Ali Reza ◽  
AKM Shafiqur Rahman
Keyword(s):  
Nutritional Status ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Nutritional Support ◽  
Nutritional Assessment ◽  
Critically Ill Patient ◽  
Developed Country ◽  
Group A ◽  
Group B ◽  
State Group

We have evaluated the effectiveness of nutritional support to critically ill patients undergoing treatment in ICU. We provided commercially prepared branded food in one group and compared this, with those of homemade preparations. Fifty adult critically ill patients getting treatment in ICU aged between 20 to 60 years having no diabetes, hypertension, ischaemic heart disease and chronic renal failure, were scheduled for providing enterai nutritional support. They were randomly allocated into two groups. Group A (n=25) received commercially prepared branded food containing balanced food consisting of protein, fat, and carbohydrate in calculated proportion. The aim was to provide 2500 Kcal of energy per day for an average adult in his/her critical state. Group B (n=25) received homemade food preparations in proper proportion of those of group A and of equal calories. The purpose of the study was to assess, formulate and compare the efficacy, tolerability and cost effectiveness of homemade prepared food with commercially formulated branded food in maintaining nutritional status of critically ill patient in ICU. Patient's nutritional assessment was done before the commencement of nutritional support, Nutritional assessment was repeated weekly for successive two weeks. Group A showed better result than Group B, significant improvement has been observed also in group B and the differences between two groups are statistically not significant Both the methods of nutritional support were adequate and effective in maintaining the nutritional status. Considering the poor socioeconomic environment in an under developed country like Bangladesh, a less costly homemade preparation can be an effective alternative over the branded food.   Journal of BSA, Vol. 20, No. 1, January 2007 p.18-23

scholarly journals Interest of Treating Iron Deficiency, Diagnosed According to Hepcidin Quantification, on Outcomes After a Prolonged Icu Stay Compared to Standard Care: A Multicenter, Randomized, Single-blinded Trial

2020 ◽  
Author(s):  
sigismond lasocki ◽  
Pierre ASFAR ◽  
Samir JABER ◽  
Martine FERRANDIERE ◽  
Thomas KERFORNE ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Critically Ill ◽  
Primary Endpoint ◽  
Critically Ill Patients ◽  
Standard Care ◽  
Intravenous Iron ◽  
Prolonged Stay ◽  
Icu Stay ◽  
Icu Discharge ◽  
Prolonged Icu Stay

Abstract Background: Anemia is a significant problem in patients on ICU. Its commonest cause, iron deficiency (ID), is difficult to diagnosed in the context of inflammation. Hepcidin is a new marker of ID. We aimed to assess whether hepcidin levels would accurately guide treatment of ID in critically ill anemic patients after a prolonged ICU stay and affect the post-ICU outcomes. Methods: In a controlled, single-blinded, multicenter study, anemic (WHO definition) critically ill patients with an ICU stay ≥5 days were randomized when discharge was expected to either intervention by hepcidin treatment protocol or control. In the intervention arm patients were treated with intravenous iron (1g of ferric carboxymaltose) when hepcidin was <20 μg/l and with intravenous iron and erythropoietin for 20≤ hepcidin <41 μg/l. Control patients were treated according to standard care (hepcidin quantification remained blinded). Primary endpoint was the number of days spent in hospital 90 days after ICU discharge (post-ICU LOS). Secondary endpoints were day 15 anemia, day 30 fatigue and day 90 mortality. Results: Of 405 randomized patients, 399 were analyzed (201 in intervention and 198 in control arm). 220(55%) had ID at discharge (i.e. an hepcidin <41 μg/l). Primary endpoint was not different (medians(IQR) post-ICU LOS 33(13;90) vs 33(11;90) days for intervention and control respectively, median difference -1(-3;1) days, p=0.78). D90 mortality was significantly lower in the intervention arm (16(8%) vs 33(16.6%) deaths, absolute risk difference -8.7 (-15.1 to -2.3)%, p=0.008). Conclusion: Treatment of ID diagnosed according to hepcidin levels did not reduce the post-ICU LOS, but may reduce the long-term mortality in critically ill patients about to be discharged after a prolonged stay. Trial Registration: www.clinicaltrial.gov NCT02276690 (October 28, 2014; Retrospectively registered)

Effect of the Mini Nutritional Assessment-Short Form (MNA-SF) in Elderly Burn Patients

2021 ◽  
Author(s):  
Jia-Yu Wei ◽  
Shu-Ting Shi ◽  
Dan Sun ◽  
Guo-Zhong Lyu
Keyword(s):  
Wound Healing ◽  
Nutritional Status ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Reference Points ◽  
Nutrition Intervention ◽  
Burn Patients ◽  
Cross Sectional

Abstract Objective Nutritional assessment can early identify patients who are malnourished and at risk of malnutrition. To examine the effect of nutritional status on wound healing in elderly burn patients, we used the MNA-SF to measure the nutritional status of elderly patients. This study aimed to examine the role of MNA-SF in elderly burn patients through the correlation analysis of wound-healing indicators and MNA-SF score. Design Prospective observational and cross-sectional study. Methods This study used the MNA-SF to investigate the elderly burn patients at the department of burn. According to the score, the patients fell into three groups: good nutritional status (more than 12 points), malnutrition risk (8~11 points), and malnutrition (0~7 points). At the same time, we measured and compared the wound-healing indicators among the three groups of patients, and detected the correlation. Results The statistical analysis found gender had a slight influence on the score of nutritional status. While age was negatively correlated with the MNA-SF score and nutrition-related indicators. There was a low positive linear correlation between the wound healing percent area change or wound healing rate of patients and the score of the MNA-SF. Conclusion This study finds malnutrition is common among hospitalized elderly burn patients. The application of the MNA-SF in elderly burn patients is efficient and accurate to identify malnutrition early and prevent further obstruction of the normal wound healing, which can provide reference points for early nutrition intervention programs.

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