critical illness ; enteral nutrition ; intensive care unit ; malnutrition ; nutrition support ; parenteral nutrition
Abstract
Background: Malnutrition is a frequent nutritional problem among ICU patients, and their nutritional status is
known to affect clinical prognosis. We conducted this study to examine nutritional status and actual nutrition delivery
in the ICU patients and its relations to clinical outcomes.
Methods: This study was a multicenter retrospective observational study based on the medical records of 163 patients
admitted to ICU of tertiary teaching hospitals in Korea. We included the patients who were treated with mechanical
ventilation for 3 or more days and received enteral or parenteral nutrition.
Results: According to albumin and total lymphocyte count levels, 54.6% of the subjects were moderately or severely
malnourished. Mean percentage of calorie and protein delivery to estimated needs for 10 days were 55.8 ±
29.3% and 46.1 ± 30.1%, respectively. While parenteral nutrition (PN) started at 1.6 ± 1.4 days after admission,
enteral nutrition (EN) did at 3.6 ± 2.1 days. Days to PN and EN start, the calorie and protein amount via EN or
PN were significantly different among 6 hospitals. No clinical outcomes differed by the levels of calorie or protein
delivery. In-hospital mortality was significantly higher in the severely malnourished group at admission as compared
to the other 2 groups (54.3% vs. 31.2% vs. 27.7%, p < 0.05)
Conclusions: Malnutrition prevalence is high among Korean intensive care unit patients, but current nutritional
therapy practice is inconsistent across institutions and far below the international guidelines. Systematic efforts should
be made to develop nutritional support guidelines for Korean ICU patients.