Translation and adaptation of the NUTRIC Score to identify critically ill patients who benefit the most from nutrition therapy

Rosa, Mariane; Heyland, Daren K.; Fernandes, Daieni; Rabito, Estela Iraci; Oliveira, Manoela Lima; Marcadenti, Aline

doi:10.1016/j.clnesp.2016.04.030

Cited by 32 publications

(32 citation statements)

References 12 publications

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“…[27][28][29] In addition, the NUTRIC score has been validated by independent investigators in Asian, Brazilian, and Portuguese populations. [30][31][32] In contrast, Arabi and colleagues 33 recently published a post hoc analysis of the Permissive Underfeeding versus Target Enteral Feeding in Critically Ill Adults (PERMIT) trial, where patients were randomized to different levels of caloric intake, and they analyzed the effect with high vs low NUTRIC groups of patients. Consistent with the overall results of the PERMIT trial, 34 they did not demonstrate any differential effect of caloric intake in high vs low NUTRIC patients.…”

Section: Nutrition Risk Assessment In the Critically Illmentioning

confidence: 99%

Protein Delivery in the Intensive Care Unit: Optimal or Suboptimal?

et al. 2017

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Emerging evidence suggests that exogenous protein/amino acid supplementation has the potential to improve the recovery of critically ill patients. After a careful review of the published evidence, experts have concluded that critically ill patients should receive up to 2.0-2.5 g/kg/d of protein. Despite this, however, recent review of current International Nutrition Survey data suggests that protein in critically ill patients is underprescribed and grossly underdelivered. Furthermore, the survey suggests that most of protein administration comes from enteral nutrition (EN) despite the availability of products and protocols that enhance the delivery of protein/amino acids in the intensive care unit (ICU) setting. While future research clarifies the dose, timing, and composition for exogenous protein administration, as well as identification of patients who will benefit the most, ongoing process improvement initiatives should target a concerted effort to increase protein intake in the critically ill. This assertion follows from the notion that current patients are possibly being harmed while we wait for confirmatory evidence. Further research should also develop better tools to enable bedside practitioners to monitor optimal or adequate protein intake for individual patients. Finally, exploring the effect of combining adequate protein delivery with early mobility and/or resistance exercise in the ICU setting has the greatest potential for improving the functional outcomes of survivors of critical illness and warrants further study.

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Section: Nutrition Risk Assessment In the Critically Illmentioning

confidence: 99%

Protein Delivery in the Intensive Care Unit: Optimal or Suboptimal?

et al. 2017

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“…Second, this sample comprised patients of a wide range of age and with different diseases. Further investigation is needed to find the best cutoff score for the high-risk group in the modified NUTRIC Score in order to compare our data with the original score used in the Caucasian cohort [17].…”

Section: Discussionmentioning

confidence: 99%

Modified NUTRIC score: a predictor for mortality in patients with septic shock-a single center retrospective study

Hou¹,

Li²,

Wu³

et al. 2020

Preprint

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Objective to evaluate the modified NUTRIC score in identifying nutritional risk patients and predicting mortality in septic shock patients. Methods A retrospective study was performed with septic shock patients admitted to the intensive care unit (ICU) from January 2018 to December 2019. A receiver operating characteristic (ROC) curve was used to identify the performance of the instruments to predict mortality. Results Among the patients, 46 patients were non-survivors and 78 were survivors. The median mNUTRIC score was 5.41±1.69 vs 4.29±1.58(P<0.0001). 28-day mortality increased with higher modified NUTRIC score. In the ROC curve of mNUTRIC score, the best cut-off point was at 4. It was identified for our sample, showing the best parameters of both sensitivity and specificity for the prediction of mortality 28 days after ICU admission. The area under the curves (AUCs) of the mNUTRIC score for predicting 28-day mortality was 0.664(95%CI:0.574, 0.746). Conclusions The modified NUTRIC score was a good nutritional risk assessment tool for septic shock patients. mNUTRIC score showed a good performance for the prediction of 28-day mortality. A new cutoff value was identified for septic shock patients.

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“…17,18 Uma vantagem do NUTRIC é sua aplicabilidade em situações em que os pacientes estão com a comunicação impossibilitada, como nos casos de ventilação mecânica, uma vez que as variáveis para a pontuação no instrumento são obtidas a partir de dados registrados rotineiramente nos prontuários médicos, justamente pela frequente limitação verbal no paciente crítico. 19 Assim, o NUTRIC parece ser uma ferramenta adequada para a avaliação do risco nutricional do paciente crítico, pois aqueles que apresentam mais disfunções respiratórias, cardíacas, renais, alterações de eletrólitos e nível de consciência reduzido parecem estar mais propensos ao risco nutricional e, portanto, se beneficiariam da terapia nutricional precoce. Apesar disso, o instrumento ainda não é validado para o monitoramento do estado nutricional.…”

Section: Discussionunclassified

Parâmetros de monitoramento do estado nutricional de idosos em estado crítico: uma revisão integrativa

Teixeira¹,

Morimoto²

2018

Geriatr., Gerontol. Aging

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Revisão integrativa realizada com a finalidade de identificar as ferramentas de triagem/avaliação nutricional do paciente idoso em estado crítico que constituem alternativas às limitações dos parâmetros tradicionais. Foram utilizadas quatro bases de dados e critérios de inclusão de artigos originais disponíveis na íntegra referentes à temática, em português e inglês, entre 2013 e 2017. As palavras-chave foram: "elderly AND critical ill AND nutritional assessment" e "elderly AND intensive care AND nutritional assessment". Nove artigos foram selecionados e divididos entre os que utilizaram parâmetros nutricionais convencionais e alternativos. Observou-se, no final do desenvolvimento, a ausência de estudos que utilizaram a análise da bioimpedância elétrica (BIA) e foram incluídos na discussão os artigos viáveis à temática do trabalho, segundo as palavras-chave "bioelectrical impedance analysis", "bioelectrical impedance vectorial analysis", "phase angle" e "intensive care". Os estudos que utilizaram o escore Nutrition Risk in Critically ill (NUTRIC), que inclui os escores Acute Physiology and Chronic Health disease Classification System II (APACHE II) e Sepsis-related Organ Failure Assessment (SOFA), e os que utilizaram esses escores isoladamente apresentaram bons resultados. Apesar do valor final do SOFA ter se mantido o mesmo nos estudos incluídos neste trabalho, nota-se que esse instrumento pode ser promissor. Sugere-se a exploração de estudos que avaliem a utilização da BIA, em pacientes idosos graves, da qual derivam o ângulo de fase, a análise vetorial da bioimpedância elétrica (BIVA) e outros que avaliem o NUTRIC associado ao ângulo de fase e/ou BIVA, nos pacientes críticos com baixo nível de consciência e/ou edema. PALAVRAS-CHAVE: envelhecimento; unidades de terapia intensiva; avaliação nutricional.

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Translation and adaptation of the NUTRIC Score to identify critically ill patients who benefit the most from nutrition therapy

Cited by 32 publications

References 12 publications

Protein Delivery in the Intensive Care Unit: Optimal or Suboptimal?

Protein Delivery in the Intensive Care Unit: Optimal or Suboptimal?

Modified NUTRIC score: a predictor for mortality in patients with septic shock-a single center retrospective study

Parâmetros de monitoramento do estado nutricional de idosos em estado crítico: uma revisão integrativa

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