Current clinical nutrition practices in critically ill patients in Latin America: a multinational observational study.

BACKGROUND: Malnutrition in critically ill adults in the intensive care unit (ICU) is associated with a significantly elevated risk of mortality. Adequate nutrition therapy is crucial to optimise outcomes. Currently, there is a paucity of such data in Latin America. Our aims were to characterise current clinical nutrition practices in the ICU setting in Latin America and evaluate whether current practices meet caloric and protein requirements in critically ill patients receiving nutrition therapy. METHODS: We conducted a cross-sectional, retrospective, observational study in eight Latin American countries (Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, Panama, and Peru). Eligible patients were critically ill adults hospitalised in the ICU and receiving enteral nutrition (EN) and/or parenteral nutrition (PN) on the Screening Day and the previous day (day -1). Caloric and protein balance on day -1, nutritional status, and prescribed nutrition therapy were recorded. Multivariable logistic regression analysis was performed to identify independent predictors of reaching daily caloric and protein targets. RESULTS: The analysis included 1053 patients from 116 hospitals. Evaluation of nutritional status showed that 74.1% of patients had suspected/moderate or severe malnutrition according to the Subjective Global Assessment. Prescribed nutrition therapy included EN alone (79.9%), PN alone (9.4%), and EN + PN (10.7%). Caloric intake met >90% of the daily target in 59.7% of patients on day -1; a caloric deficit was present in 40.3%, with a mean (±SD) daily caloric deficit of -688.8 ± 455.2 kcal. Multivariable logistic regression analysis showed that combined administration of EN + PN was associated with a statistically significant increase in the probability of meeting >90% of daily caloric and protein targets compared with EN alone (odds ratio, 1.56; 95% confidence interval, 1.02-2.39; p = 0.038). CONCLUSIONS: In the ICU setting in Latin America, malnutrition was highly prevalent and caloric intake failed to meet targeted energy delivery in 40% of critically ill adults receiving nutrition therapy. Supplemental administration of PN was associated with improved energy and protein delivery; however, PN use was low. Collectively, these findings suggest an opportunity for more effective utilisation of supplemental PN in critically ill adults who fail to receive adequate nutrition from EN alone.

Introducción al análisis factorial exploratorio / Introduction to exploratory factor analysis (EFA)

Introducción: El análisis factorial exploratorio (AFE) se ha convertido en una de las técnicas estadísticas más utilizadas en la actualidad, especialmente en las áreas médicas y sociales. Dada esta popularidad, es fundamental conocer y, a la vez, profundizar en los conceptos básicos necesarios para su correcta aplicación, considerando las principales fortalezas y debilidades que presenta esta técnica. Objetivo: Presentar de una manera clara y concisa cuáles son las principales aplicaciones de esta técnica, así como determinar los requisitos básicos para su utilización, hacer una descripción paso a paso de su metodología y establecer cuáles son los elementos que se deben tener en cuenta durante su elaboración, con el fin de no incurrir en resultados e interpretaciones erróneas. Metodología: Revisión narrativa. Desarrollo: En esta revisión se identificaron los conceptos básicos y se hizo una breve descripción de los objetivos, diseño, supuestos, metodología para derivar los factores y evaluar el ajuste global, así como de la adecuada interpretación de los resultados…

Introduction: Exploratory Factor Analysis (EFA) has become one of the most frequently used statistical techniques, especially in the medical and social sciences. Given its popularity, it is essential to understand the basic concepts necessary for its proper application and to take into consideration the main strengths and weaknesses of this technique. Objective: To present in a clear and concise manner the main applications of this technique, to determine the basic requirements for its use providing a description step by step of its methodology, and to establish the elements that must be taken into account during its preparation in order to not incur in erroneous results and interpretations. Methodology: Narrative review. Development: This review identifies the basic concepts and briefly describes the objectives, design, assumptions, and methodology to achieve factor derivation, global adjustment evaluation, and adequate interpretation of results…

[Introduction to Exploratory Factor Analysis (EFA)]. / Introducción al análisis factorial exploratorio.

INTRODUCTION: Exploratory Factor Analysis (EFA) has become one of the most frequently used statistical techniques, especially in the medical and social sciences. Given its popularity, it is essential to understand the basic concepts necessary for its proper application and to take into consideration the main strengths and weaknesses of this technique. OBJECTIVE: To present in a clear and concise manner the main applications of this technique, to determine the basic requirements for its use providing a description step by step of its methodology, and to establish the elements that must be taken into account during its preparation in order to not incur in erroneous results and interpretations. METHODOLOGY: Narrative review. DEVELOPMENT: This review identifies the basic concepts and briefly describes the objectives, design, assumptions, and methodology to achieve factor derivation, global adjustment evaluation, and adequate interpretation of results.