P045 the Relationship Between Calories Received and Clinical Outcomes in Critically Ill Patients: Results of an International Multicenter Observational Study

Creating a Culture of Clinical Excellence in Critical Care Nutrition

“…The variable and suboptimal nutrition performance of some of these participating sites needs to be considered in light of emerging data that suggest that inadequate delivery of energy and protein is associated with increased mortality. Using our data set of 2772 ICU patients from 167 ICUs derived from the international audit in 2007, we showed a significant inverse linear relationship between the odds of mortality and total daily calories received 29 . An increase of 1000 calories per day was associated with an overall reduction in mortality (odds ratio for 60‐day mortality = 0.79; 95% confidence intervals [CIs]: 0.65‐0.97; P = .02) and an increase in ventilator‐free days (2.47; 95% CI: 0.54‐4.41; P = .01).…”

“…We justify the inclusion of these criteria because each component (overall adequacy, timing and amount of EN, and glycemic control) has been shown to correlate with clinical outcomes (complications, length of stay, and mortality) 16 . ‐ 18 …”

Volume‐Based Feeding in the Critically Ill Patient

“…The net effect of all these errors is that patients get only half of what they should receive based on actual caloric requirements (a number that is surprisingly consistent, between 51.3% and 59.0% of goal calories, across North America). 1,[3][4][5] Critically ill patients who get only 50% of goal calories infused day after day in the ICU setting (based on energy requirements) quickly generate a substantial caloric deficit; the larger the deficit, the worse the clinical outcome. Earlier studies focused on a specific calorie deficit of 10,000 kcal.…”

Is There a Discrepancy? Comparing Enteral Nutrition Documentation With Enteral Pump Volumes

“…Robust standard errors were generated using the Huber‐White sandwich estimator. All statistical analyses were performed in STATA 14 (StataCorp LP, College Station, TX) 4 . Level of significance was set at P < .05.…”