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Titre : | Nutritional status evaluation in critical care: A study of clinical practices (2023) |
Auteurs : | Achwak Mehrez ; Om Kalthoum Sallem ; Hela Attia ; Karim Masmoudi ; Kais Gardabou ; Ali Majdoub |
Type de document : | Article |
Dans : | Nutrition clinique et métabolisme (vol. 37, no. 1, février 2023) |
Article en page(s) : | p. 51-55 |
Note générale : | https://doi.org/10.1016/j.nupar.2022.11.001 |
Langues: | Anglais |
Descripteurs : |
HE Vinci État nutritionnel ; Évaluation de l'état nutritionnel ; Soins de réanimation |
Mots-clés: | Évaluation des pratiques cliniques |
Résumé : |
Background & aims
Malnutrition is a common consequence in critically ill patients admitted to the intensive care unit (ICU). Objective The aim of this study was to assess the current clinical practices concerning nutritional screening and assessment in multiple Tunisian intensive care units. Methods The study was conducted through a survey. It was intended for all intensivists: certified specialists and residents. The content of the questionnaire was guided by literature review and latest Clinical Practice Guidelines. Results This study involved 105 physicians. Concerning the nutritional status screening: the clinical history and disease related effects were considered by 70% of physicians and weight changes were considered in 60%. Screening a recent and unintentional weight loss before hospital or ICU admission was done by 90% of intensivists. While only 45% screened the reduced dietary intake. Physical signs of malnutrition (loss of subcutaneous fat or muscle mass, oedema, ascite) were assessed by 52% of respondents. Using scores to evaluate the risk of malnutrition was considered by 26% of physicians. Weight evaluation based on actual body weight and BMI calculation were practiced by 59% of respondents. In order to evaluate the energy expenditure, indirect calorimetry (IC) was performed in 20% and predictive equations were used in 27%. Only 7% of respondents used VO2/VCO2 (VO2 (oxygen consumption) from pulmonary arterial catheter or VCO2 (carbon dioxide production) derived from the ventilator) measurement method. Over the half of the respondents (54%) had fixed a caloric target of 20 to 25 Kcal/day. Whereas, 16% of respondents reported that they did not consider the correct optimal calorie target. Albumin was prescribed by the majority of respondents (99%) to assess the nutritional state. Other biochemical parameters as Prealbumin and Transferrin were only known and prescribed in 8% and 7% respectively. Conclusion Results have shown that physicians responded differently regarding nutritional evaluation and that they were globally not sensibilized by the importance of this step. We highlight the necessity of an appropriate nutrition screening and assessment that will set the basis of an effective nutritional management. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0985056222001029 |