Nutrition in the intensive care unit and early recovery influence functional outcomes for survivors of critical illness: A prospective cohort study.

Autor: Jubina LE; Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, Kentucky, USA., Locke A; Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, Kentucky, USA., Fedder KR; Department of Clinical Nutrition, University of Kentucky HealthCare, Lexington, Kentucky, USA., Slone SA; Dr. Bing Zhang Department of Statistics, College of Arts & Sciences, University of Kentucky, Lexington, Kentucky, USA., Soper MK; Division of Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, College of Medicine, University of Kentucky, Lexington, Kentucky, USA., Kalema AG; Division of Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, College of Medicine, University of Kentucky, Lexington, Kentucky, USA.; Kentucky Research Alliance for Lung Disease, Office of Research, College of Medicine, University of Kentucky, Lexington, Kentucky, USA., Montgomery-Yates AA; Division of Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, College of Medicine, University of Kentucky, Lexington, Kentucky, USA.; Kentucky Research Alliance for Lung Disease, Office of Research, College of Medicine, University of Kentucky, Lexington, Kentucky, USA., Mayer KP; Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, Kentucky, USA.; Kentucky Research Alliance for Lung Disease, Office of Research, College of Medicine, University of Kentucky, Lexington, Kentucky, USA.
Jazyk: angličtina
Zdroj: JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2023 Sep; Vol. 47 (7), pp. 888-895. Date of Electronic Publication: 2023 Jul 21.
DOI: 10.1002/jpen.2538
Abstrakt: Background: Patients who are critically ill may receive suboptimal nutrition that leads to weight loss and increased risk of functional deficits.
Methods: Our overarching hypothesis is that nutrition in the intensive care unit (ICU) and the early recovery phase associates with functional outcomes at short-term follow-up. We enrolled adult patients who attended the University of Kentucky ICU recovery clinic (ICU-RC) from November 2021 to June 2022. Patients participated in muscle and functional assessments. Nutrition intake and status during the ICU stay were analyzed. The Subjective Global Assessment and a nutrition questionnaire were used to identify changes in intake, ongoing gastrointestinal symptoms, and patient's access to food at the ICU-RC appointment.
Results: Forty-one patients enrolled with a median hospital length of stay (LOS) of 23 days. Patients with 0 days of nil per os (NPO) status throughout hospitalization had a shorter LOS (P = 0.05), were able to complete the five times sit-to-stand test (P = 0.02), and were less likely to experience ICU-acquired weakness (P = 0.04) at short-term follow-up compared with patients with ≥1 day of NPO status. Twenty (48%) patients reported changes in nutrition intake in early recovery compared with before hospitalization. Eight (20%) patients reported symptoms leading to decreased intake and four (10%) reported access to food as a barrier to intake.
Conclusion: Barriers to nutrition exist during critical illness and persist after discharge, with almost half of patients reporting a change in intake. Inpatient nutrition intake is associated with functional outcomes and warrants further exploration.
(© 2023 American Society for Parenteral and Enteral Nutrition.)
Databáze: MEDLINE
Externí odkaz: