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O combate à pandemia da COVID-19 se tornou o grande desafio atual, e a terapia nutricional é parte fundamental do cuidado integral na atenção ao paciente crítico. A maioria dos pacientes contaminados tem sido tratada em casa, em isolamento domiciliar. Entretanto, uma parte destes pacientes complica e necessita hospitalização, e cerca de 5% precisam de terapia intensiva. Neste subgrupo, as complicações mais frequentes são a disfunção respiratória, seguida da disfunção renal. Sendo assim, BRASPEN/AMIB divulgam, a seguir, sugestões para orientar as equipes multidisciplinares de terapia nutricional (EMTNs) no nosso País

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Background Malnutrition is prevalent in trauma victims because of intense muscle wasting triggered by traumatic events and is a mortality risk. The Academy of Nutrition and Dietetics–American Society for Parenteral and Enteral Nutrition (AND‐ASPEN) tool has the potential to diagnose malnutrition in this population. This study aims to evaluate this criterion as a malnutrition diagnostic tool and as a hospital mortality predictor in critically ill trauma patients. Methods We performed an observational prospective cohort study from April 2015 to February 2017 in a Brazilian hospital. Patients were >18 years old, remained in the intensive care unit (ICU) >48 hours, and had completed data regarding the recommended clinical characteristics (RCCs) for malnutrition. The main exposure of interest was malnutrition assessed by a specialist dietitian using AND‐ASPEN. The primary outcome was all causes of mortality during hospital stay. Secondary outcome was the RCCs assessment, to predict malnutrition and hospital mortality. Results Included were 414 trauma patients. Malnutrition prevalence was 26.8% at ICU admission. The main analysis showed that malnutrition increases mortality chances 1.96 times (95% CI, 1.13–3.30; P = .015). Secondary analysis showed that all 5 RCCs were significantly associated with malnutrition. The only RCC associated with mortality was energy intake (odds ratio 1.5; 95% CI, 1.1–2.0; P = .008). Conclusions AND‐ASPEN criterion is a feasible and accurate method to recognize malnutrition and predict hospital mortality when applied by trained dietitians for the critical care trauma population. Further studies are needed considering patient subgroups such as obese and elderly.

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