Korean J Crit Care Med.  2012 Aug;27(3):157-164. 10.4266/kjccm.2012.27.3.157.

Nutrition Support in the Intensive Care Unit of 6 Korean Tertiary Teaching Hospitals: A National Multicenter Observational Study

Affiliations
  • 1Department of Nutrition Services, Gangnam Severance Hospital, Seoul, Korea.
  • 2Department of Nutrition Services, Chonbuk National University Hospital, Jeonju, Korea.
  • 3Department of Food Service and Nutrition Care, Seoul National University Hospital, Seoul, Korea.
  • 4Department of Dietetics, Samsung Medical Center, Seoul, Korea.
  • 5Department of Nutrition Services, Hanyang University Seoul Hospital, Seoul, Korea.
  • 6Department of Food and Nutrition, Sungshin Women's University, Seoul, Korea.
  • 7Department of Nutrition and Dietetics, Severance Hospital, Seoul, Korea.
  • 8Department of Anethesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. cheung56@yuhs.ac

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.

Keyword

critical illness; enteral nutrition; intensive care unit; malnutrition; nutrition support; parenteral nutrition

MeSH Terms

Critical Illness
Enteral Nutrition
Hospital Mortality
Hospitals, Teaching
Humans
Critical Care
Intensive Care Units
Korea
Lymphocyte Count
Malnutrition
Medical Records
Nutritional Status
Nutritional Support
Parenteral Nutrition
Prevalence
Prognosis
Respiration, Artificial
Retrospective Studies
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