[Degree of nutritional training of intensive care physicians. A survey in public hospitals of Asunción]. / Nivel de formación en nutrición de médicos intensivistas. Encuesta en hospitales púiblicos de Asunción.

ABSTRACT

UNLABELLED Nutritional support in the critically ill patient is an important mainstay within the specialty of intensive care medicine. Patients at the Intensive Care Unit (ICU) are usually hypercatabolic and require an adequate nutritional support. Usually, the intensive care physician prescribes nutrition type, its amount, and follow-up of patients; however, the qualification of these physicians regarding clinical nutrition is unknown. OBJECTIVE: to investigate the degree of knowledge on artificial nutrition and the interest on nutrition of intensive care physicians. METHODOLOGY: a prospective survey was done on 60 intensive care physicians from three public hospitals of Asunción (22 staff physicians and 38 internal residents), with a mean age of 34 +/- 6 years, and a mean professional practice of 5.8 +/- 6 years. The survey contained 10 questions and multiple-choice answers to determine the degree of knowledge depending on the grade obtained, and 5 questions on personal training and attitude towards nutritional support in the ICU. RESULTS: 98.3% of surveyed physicians considered that nutritional support of the ICU-admitted patient has an effect on morbidity and mortality of patients. Nevertheless, 88.3% of physicians considered their nutritional training in the ICU as insufficient. Seventy percent do not usually read papers on nutrition on scientific journals. Only 25% of them formulate parenteral nutrition, and 30% have attended a course on nutrition in the ICU within the last 5 years. The final grade for the 10 questions, the maximum grade possible being 10, was 6.1 +/- 1.9 for staff physicians, and 5.59 +/- 2.3 for internal residents (p = 0.3). When analyzing the correct answers by years of practice, the mean grade was 5.2 +/- 2.3 in those with less than 2 years of practice versus 6.4 +/- 1.7 in those with more than 2 years of practice (p = 0.02). CONCLUSIONS: nutritional training in intensive care medicine is incomplete and the degree of knowledge on nutrition in the critically ill patient is insufficient, being lower in physicians with a limited practice in the ICU. These results suggest the urgent need for training on clinical nutrition of intensive care physicians for the care of the critically ill patient being complete.