Recomendaciones para el soporte nutricional y metabólico especializado del paciente crítico. Actualización. Consenso SEMICYUC-SENPE: Indicaciones, momento de inicio y vías de aporte

Fernández-Ortega, J.F.; Meseguer, Juan; García, P. Martínez

doi:10.1016/s0210-5691(11)70002-x

Cited by 15 publications

(24 citation statements)

References 29 publications

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“…Notwithstanding the particular circumstances of each study protocol, the consensus proposed by McClave et al (6) and the Spanish consensus of NT in intensive care (24) suggest that the nutritional goal has to be reached within 48 to 72 hours, and our results are in agreement with those values. The algorithm proposed by the PEP uP protocol considers that, if 80% of the caloric goal is not achieved within 72 hours and the patient is at high risk, then the use of prokinetic agents is indicated, and the feeding tube should be placed in the intestinal region to help achieve the nutritional goal.…”

Section: Discussionsupporting

confidence: 89%

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Adequacy of energy and protein balance of enteral nutrition in intensive care: what are the limiting factors?

Ribeiro¹,

Filho²,

Caruso³

et al. 2014

Revista Brasileira De Terapia Intensiva

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Objective To determine the factors that influence the adequacy of enteral nutritional therapy in an intensive care unit.Methods This prospective observational study was conducted in an intensive care unit between 2010 and 2012. Patients >18 years of age underwent exclusive enteral nutritional therapy for ≥72 hours. The energy and protein requirements were calculated according to the ICU protocols. The data regarding enteral nutrition, the causes of non-compliance, and the biochemical test results were collected daily.Results Ninety-three patients admitted to the intensive care unit were evaluated. Among these patients, 82% underwent early enteral nutritional therapy, and 80% reached the nutritional goal in <36 hours. In addition, 81.6%±15.4% of the enteral nutrition volume was infused, with an adequacy of 82.2%±16.0% for calories, 82.2%±15.9% for proteins, and a mean energy balance of -289.9±277.1kcal/day. A negative correlation of C-reactive protein with the volume infused and the energy and protein balance was observed. In contrast, a positive correlation was found between C-reactive protein and the time required to reach nutritional goals. Extubation was the main cause for interrupting the enteral nutritional therapy (29.9% of the interruption hours), and the patients >60 years of age exhibited a lower percentage of recovery of the oral route compared with the younger patients (p=0.014).Conclusion Early enteral nutritional therapy and the adequacy for both energy and protein of the nutritional volume infused were in accordance with the established guidelines. Possible inadequacies of energy and protein balance appeared to be associated with an acute inflammatory response, which was characterized by elevated C-reactive protein levels. The main cause of interruption of the enteral nutritional therapy was the time spent in extubation.

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Section: Discussionsupporting

confidence: 89%

“…Early ENT (24-48 hours) has been associated with fewer clinical complications, a gradual decrease in mortality, and a decreased duration of stay in the ICU. (21,24) …”

Section: Discussionmentioning

confidence: 99%

Adequacy of energy and protein balance of enteral nutrition in intensive care: what are the limiting factors?

Ribeiro¹,

Filho²,

Caruso³

et al. 2014

Revista Brasileira De Terapia Intensiva

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“…El restablecimiento de la funcionalidad perdida es el objetivo del tratamiento, lo que implica hacer un abordaje según las necesidades de cada paciente. Es decir, se debe entender que, dada la complejidad del tracto gastrointestinal, no hay una única forma de manejo nutricional y médico para estas situaciones, ya que frecuentemente derivan en múltiples desenlaces clínicos que cruzan de diferente manera de la insuficiencia a falla intestinal, por lo que se requiere un manejo médico y nutricional específicos (1,15) .…”

Section: Diferencias De Las Clasificaciones De Falla Intestinalunclassified

De la insuficiencia a la falla intestinal, un camino de doble sentido que cruza con la malnutrición

Trejos¹,

Correa

Narváez-Solarte

2021

Rev. Nutr. Clin. Metab.

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Introducción: actualmente, la insuficiencia y la falla intestinal están presentes en cerca del 60 % de los pacientes en unidades de cuidado intensivo en el mundo, siendo más frecuente la presencia de insuficiencia. El objetivo de esta revisión es presentar la evidencia actual sobre la relación de la insuficiencia, la falla intestinal y su influencia en el desarrollo de la malnutrición hospitalaria. Métodos: se realizó una búsqueda en Medline y PubMed de las publicaciones que incluyeran las palabras clave “insuficiencia intestinal”, “falla intestinal”, “soporte nutricional”, “malnutrición hospitalaria”, de artículos en inglés y español. Resultados: la presencia de falla e insuficiencia intestinal aumenta la probabilidad de malnutrición en el paciente en estado crítico debido a que la absorción de nutrientes se ve disminuida y, por ende, lo hace más vulnerable a desarrollar una mayor pérdida de peso, lo que aumenta su morbimortalidad. Además, la estancia hospitalaria de los pacientes es más prolongada, y genera altos costos al sistema de salud. Esto se debe a que frecuentemente se presentan infecciones y complicaciones asociadas con la desnutrición y la pérdida de productividad, lo que disminuye la calidad de vida, con efectos negativos sobre el entorno social. Conclusiones: la insuficiencia y falla intestinal son situaciones que pueden generarse de manera bidireccional. Las diferencias en la clasificación de la falla intestinal según las diversas asociaciones afectan el manejo de los pacientes. Palabras clave: insuficiencia intestinal, falla intestinal, soporte nutricional, malnutrición hospitalaria.

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“…In case of enteral nutrition, feeding should be started early within the first 24 - 48 hours following admission to facilitate diet tolerance, reduce the risk of intestinal barrier dysfunction and infections, and reduce the length of hospital stay and mechanical ventilation [4]. …”

Section: Indications Contraindications and Complications Of Enteral mentioning

confidence: 99%

Enteral Nutrition in Critical Care

et al. 2013

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There is a consensus that nutritional support, which must be provided to patients in intensive care, influences their clinical outcome. Malnutrition is associated in critically ill patients with impaired immune function and impaired ventilator drive, leading to prolonged ventilator dependence and increased infectious morbidity and mortality. Enteral nutrition is an active therapy that attenuates the metabolic response of the organism to stress and favorably modulates the immune system. It is less expensive than parenteral nutrition and is preferred in most cases because of less severe complications and better patient outcomes, including infections, and hospital cost and length of stay. The aim of this work was to perform a review of the use of enteral nutrition in critically ill patients.

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Recomendaciones para el soporte nutricional y metabólico especializado del paciente crítico. Actualización. Consenso SEMICYUC-SENPE: Indicaciones, momento de inicio y vías de aporte

Cited by 15 publications

References 29 publications

Adequacy of energy and protein balance of enteral nutrition in intensive care: what are the limiting factors?

Adequacy of energy and protein balance of enteral nutrition in intensive care: what are the limiting factors?

De la insuficiencia a la falla intestinal, un camino de doble sentido que cruza con la malnutrición

Enteral Nutrition in Critical Care

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