Purpose: Several studies that focused on hospital malnutrition have reported that more than 40% of hospitalized patients have nutritional risk factors, and there is a high prevalence of hospital malnutrition. People with a more severe malnutrition status had a longer length of hospital stay and higher hospital costs. Therefore, the net result from early nutritional support may be improved organ function, decreased infection, reduced morbidity and mortality and decrease the hospital stay and cost. Methods: We investigated the patients who received tube feeding or parenteral nutrition for more than 3 days. We recommended the nutritional assessment, the patients' requirements, the route of feeding and the proper formula to the clinicians. Some of them followed our suggestion and some didn't. Thus, we divided groups into two subgroups according to this. The clinical outcomes of the two groups were compared. Results: There were no significant differences in the clinical outcomes between the two groups. However, the patients who received enteral feeding increased from 10% up to 70% in the experiment group. In spite that the gastrointestinal route could have been used, only 44.4% of the patients in the control group received enteral feeding. Conclusion: More rapid and adequate nutritional support through enteral nutrition must be considered to produce the effective clinical outcomes in critically ill patients. The patients who require nutritional support need continuous follow up care and monitoring by a nutritional support team (NST). (KJPEN 2010;3(1):40-44) 서 론 입원환자의 40% 이상이 영양불량 위험요인을 가지고 있 고, 약 75%의 환자가 입원 기간 중 영양불량이 악화되고 있으며, 1 영양불량이 심할수록 합병증, 사망률이 증가되고 재원일수가 길어지며, 환자 개인의 의료비용까지 상승되고 있음은 이미 많이 보고되고 있다. 2,3 그러므로, 환자는 입원 당시부터 신속한 영양상태 판정과 계획된 영양치료가 필요 하며, 4,5 특히 중환자에 있어서 적극적인 영양지원과 적절한 영양공급은 더욱 중요성을 가지게 된다. 6 영양집중지원은 중환자 치료와 병행하여 우선적으로 시행되어야 하며, 근 거중심의학(evidence-based medicine)의 관점에 따라 적절한 영양지원을 하는 것이 필요하다고 권고되고 있다. 7 그러나, 의료진들은 영양지원의 필요성을 과소평가하고, 영양지원 을 제대로 하지 못하여 중환자들이 부적절한 영양지원을 받게 되는 경우가 많이 있다. 특히, 영양소의 소화와 흡수에 문제가 없는 환자에서 조기 경장영양은 우선적으로 고려되 어야 하지만 현실적으로는 잘 이루어지지 않은 것이 실정 이다. 따라서, 본원 영양집중지원팀(Nutrition Support Team, NST)은 중환자실에 입원한 환자를 대상으로 단기간 내 적 절한 영양지원을 시행함으로써 환자의 영양불량 상태를 개 선하고 합병증 발생률을 낮출 뿐만 아니라 중환자실 재원 일수 및 총 재원일수를 감소시키는지 확인하고자 하였다. 더불어 영양지원의 중요성에 대한 의료진의 인식을 높여 환자의 영양불량 예방 및 치료에 기여하고자 한다.
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