Education program on medical nutrition and length of stay of critically ill patients

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art_CASTRO_Education_program_on_medical_nutrition_and_length_of_2013.PDF (484.47 KB)
Citações na Scopus
21
Tipo de produção
article
Data de publicação
2013
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
CHURCHILL LIVINGSTONE
Autores
HORIE, Lilian Mika
Citação
CLINICAL NUTRITION, v.32, n.6, p.1061-1066, 2013
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background & aims: To evaluate the impact of a multifaceted nutritional educational intervention on the quality of nutritional therapy and clinical outcomes in critically ill patients. Methods: We conducted a prospective, non-blinded study with a non-contemporaneous control group at a 16-bed intensive care unit (ICU) at the Hospital das Clinicas, Department of Gastroenterology, University of Sao Paulo Medical School in Sao Paulo, Brazil. There were three phases. Phase 1: the quality of NT was evaluated in 50 newly admitted intensive care unit patients in a pre-educational program (Pre-EP). Phase 2: nutritional protocols were created and an education program was implemented. Phase 3: another 50 patients were enrolled and observed in a post-educational program (Post-EP) using phase 1 methodology. Nutritional Therapy practice was evaluated through nutritional assessments, adequacy of energy requirements, duration of fasting, and use of early enteral nutrition. Intensive care unit length of stay and hospital length of stay were measured as primary end-points. Results: The pre-educational program and post-educational program groups did not differ in age, APACHE II score, gender, or nutritional assessment. The mean +/- SD duration of fasting decreased (Pre-EP 3.8 +/- 3.1 days vs. Post-EP: 2.2 +/- 2.6 days; p = 0.002), the adequacy of nutritional therapy improved (Pre-EP 74.2% +/- 33.3% vs. Post-EP 96.2% +/- 23.8%; p < 0.001), and enteral nutrition was initiated earlier than 48 h more commonly (Pre-EP 24% vs. Post-E 60%; p = 0.001). Median intensive care unit length of stay decreased (Pre-EP: 18.5 days vs. Post-EP: 9.5 days; p < 0.001) although hospital length of stay did not. Conclusion: Implementing a multifaceted nutritional educational intervention could improve the quality of nutritional therapy and may decrease intensive care unit length of stay in critically ill patients.
Palavras-chave
Educational program, Critical care, Nutritional therapy
URI
https://observatorio.fm.usp.br/handle/OPI/4055
Referências
  1. Adams KM, 2010, NUTR CLIN PRACT, V25, P471, DOI 10.1177/0884533610379606
  2. Adams KM, 2010, ACAD MED, V85, P1537, DOI 10.1097/ACM.0b013e3181eab71b
  3. Alberda C, 2009, INTENS CARE MED, V35, P1728, DOI 10.1007/s00134-009-1567-4
  4. Behara AS, 2008, JPEN-PARENTER ENTER, V32, P113, DOI 10.1177/0148607108314763
  5. Berger MM, 2010, JPEN-PARENTER ENTER, V34, P606, DOI 10.1177/0148607110377466
  6. Buchan H, 2004, MED J AUSTRALIA, V180, pS48
  7. Cahill NE, 2010, JPEN-PARENTER ENTER, V34, P653, DOI 10.1177/0148607110361907
  8. DeChicco R, 2010, NUTR CLIN PRACT, V25, P481, DOI 10.1177/0884533610379814
  9. Doig GS, 2008, JAMA-J AM MED ASSOC, V300, P2731, DOI 10.1001/jama.2008.826
  10. Doig GS, 2009, INTENS CARE MED, V35, P2018, DOI 10.1007/s00134-009-1664-4
  11. Drover JW, 2010, JPEN-PARENTER ENTER, V34, P644, DOI 10.1177/0148607110372391
  12. Finfer S, 2009, NEW ENGL J MED, V360, P1283, DOI 10.1056/NEJMoa0810625
  13. Garavel M, 1988, NUTR SUPPORT SERVICE, V18, P19
  14. Goiburu-Bianco M E, 2005, Nutr Hosp, V20, P326
  15. Heyland DK, 2003, JPEN-PARENTER ENTER, V27, P355, DOI 10.1177/0148607103027005355
  16. Heyland DK, 2001, JAMA-J AM MED ASSOC, V286, P944, DOI 10.1001/jama.286.8.944
  17. Jain MK, 2006, CRIT CARE MED, V34, P2362, DOI 10.1097/01.CCM.0000234044.91893.9C
  18. Jones NE, 2008, JAMA-J AM MED ASSOC, V300, P2798, DOI 10.1001/jama.2008.814
  19. KELLY TWJ, 1983, CRIT CARE MED, V11, P7, DOI 10.1097/00003246-198301000-00003
  20. KNAUS WA, 1985, CRIT CARE MED, V13, P818, DOI 10.1097/00003246-198510000-00009
  21. Mackenzie SL, 2005, JPEN-PARENTER ENTER, V29, P74, DOI 10.1177/014860710502900274
  22. McClave SA, 2009, JPEN-PARENTER ENTER, V33, P277, DOI 10.1177/0148607109335234
  23. Minard G, 2000, JPEN-PARENTER ENTER, V24, P145, DOI 10.1177/0148607100024003145
  24. MOORE FA, 1992, ANN SURG, V216, P172, DOI 10.1097/00000658-199208000-00008
  25. Mowe M, 2008, CLIN NUTR, V27, P196, DOI 10.1016/j.clnu.2007.10.014
  26. Mullen JT, 2009, ANN SURG, V250, P166, DOI 10.1097/SLA.0b013e3181ad8935
  27. Rubinson L, 2004, CRIT CARE MED, V32, P350, DOI 10.1097/01.CCM.0000089641.06306.68
  28. Singer P, 2009, CLIN NUTR, V28, P387, DOI 10.1016/j.clnu.2009.04.024
  29. Soguel L, 2012, CRIT CARE MED, V40, P412, DOI 10.1097/CCM.0b013e31822f0ad7
  30. Stapleton RD, 2007, CRIT CARE MED, V35, pS535, DOI 10.1097/01.CCM.0000279204.24648.44
  31. WEINSIER RL, 1991, AM J CLIN NUTR, V54, P957
  32. Wilmore DW, 2002, CRIT CARE MED, V30, P2153, DOI 10.1097/01.CCM.0000025890.56902.AB

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Artigos e Materiais de Revistas Científicas - FM/MGT
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