ESPEN 2021 Late Breaking Abstracts
Topic: Critical care
Abstract Submission Identifier: ESPEN21-LB-1941
AN AUDIT ON NUTRITION DELIVERY AND PATIENTS' OUTCOME IN THE INTENSIVE CARE UNIT
Y. Huang 1, 1, P. Li 1, S. Moh 1, A. Wong*, 1
1Dietetic and Food Services, CHANGI GENERAL HOSPITAL, Singapore, Singapore
Rationale: Optimal nutrition delivery in the intensive care unit (ICU) is essential in reducing complications and improving patient's outcome. The audit aims to survey prevalent enteral nutrition practices in a Singapore hospital and improve the unit's quality of nutrition care.
Methods: Data were collected prospectively from medical and surgical ICU patients from August to December 2019. Information collected includes demographics, nutrition data (Subjective Global Assessment for nutritional status, caloric and protein intake) and clinical outcomes (length of stay, mortality. Data were collected for up to 7 days during patients' stay. Results were reported as mean ± S.D. or median (IQR).
Results: Three hundred and ninety-four patients were included in the audit. Cardiovascular related conditions accounted for most of the ICU admissions (32.5%). The 30 and 90-day mortality rates were 20.6% and 22.8%. Feeding was initiated in 83.8% of patients within 48 hours of ICU admission. Hemodynamic instability is one of the main reasons (55%) for delayed feeding. More than 40% of the patients were malnourished. The median length of ICU stay is three days (IQR 2,5; range 1-146), and 81% of patients received ≥1 (IQR 1,2; range 0-4) dietetic review during the ICU stay. Patients had a mean daily deficit of 391.5±344.5 kCal and 16.7±15.0g protein. Common reasons for not meeting prescribed nutrition include withholding feeds due to hemodynamic instability (3.0%-46.5%) and non-operative procedures (extubation) (5.5%-71.8%) during the audit days. Approximately 35% of patients met ≤ 75% of their nutritional requirement post ICU discharge.
Conclusion: Nutrition support was initiated within an appropriate timeframe, but patients were not meeting their prescribed nutritional requirements during their ICU stay. Feeding interruptions during ICU stay is unavoidable, but this may negatively impact the patient's nutritional status, leading to poorer outcomes. A review of current practice to maximise nutrient delivery during and post ICU stay is needed.
References: Nil
Disclosure of Interest: None Declared
Keywords: Critical Care Nutrition, nutrition support