Near-target caloric intake in critically ill medical-surgical patients is associated with adverse outcomes.
JPEN J Parenter Enteral Nutr
; 34(3): 280-8, 2010.
Article
em En
| MEDLINE
| ID: mdl-20467009
ABSTRACT
BACKGROUND:
The objective of this study was to determine whether caloric intake independently influences mortality and morbidity of critically ill patients.METHODS:
The study was conducted as a nested cohort study within a randomized controlled trial in a tertiary care intensive care unit (ICU). The main exposure in the study was average caloric intake/target for the first 7 ICU days. The primary outcomes were ICU and hospital mortality. Secondary outcomes included ICU-acquired infections, ventilator-associated pneumonia (VAP), duration of mechanical ventilation days, and ICU and hospital length of stay (LOS). The authors divided patients (n = 523) into 3 tertiles according to the percentage of caloric intake/target tertile I <33.4%, tertile II 33.4%-64.6%, and tertile III >64.6%. To adjust for potentially confounding variables, the authors assessed the association between caloric intake/target and the different outcomes using multivariate logistic regression for categorical outcomes (tertile I was used as reference) and multiple linear regression for continuous outcomes.RESULTS:
Tertile III was associated with higher adjusted hospital mortality, higher risk of ICU-acquired infections, and a trend toward higher VAP rate. Increasing caloric intake was independently associated with a significant increase in duration of mechanical ventilation, ICU LOS, and hospital LOS.CONCLUSIONS:
The data demonstrate that near-target caloric intake is associated with significantly increased hospital mortality, ICU-acquired infections, mechanical ventilation duration, and ICU and hospital LOS. Further studies are needed to explore whether reducing caloric intake would improve the outcomes in critically ill patients.
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Base de dados:
MEDLINE
Assunto principal:
Cuidados Pós-Operatórios
/
Respiração Artificial
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Ingestão de Energia
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Infecção Hospitalar
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Estado Terminal
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Cuidados Críticos
Idioma:
En
Ano de publicação:
2010
Tipo de documento:
Article