Intensive medical nutrition therapy: methods to improve nutrition provision in the critical care setting.

Journal of the Academy of Nutrition and Dietetics
Patricia M SheeanCarol A Braunschweig

Abstract

Patients requiring mechanical ventilation in an intensive care unit commonly fail to attain enteral nutrition (EN) infusion goals. We conducted a cohort study to quantify and compare the percentage of energy and protein received between standard care (n=24) and intensive medical nutrition therapy (MNT) (n=25) participants; to assess the percentage of energy and protein received varied by nutritional status, and to identify barriers to EN provision. Intensive MNT entailed providing energy at 150% of estimated needs, using only 2.0 kcal/cc enteral formula and 24-hour infusions. Estimated energy and protein needs were calculated using 30 kcal/kg and 1.2 g protein/kg actual or obesity-adjusted admission body weight. Subjective global assessment was completed to ascertain admission intensive care unit nutritional status. Descriptive statistics and survival analyses were conducted to examine time until attaining 100% of feeding targets. Patients had similar estimated energy and protein needs, and 51% were admitted with both respiratory failure and classified as normally nourished (n=25/49). Intensive MNT recipients achieved a greater percentage of daily estimated energy and protein needs than standard care recipients (1,198±493 vs 47...Continue Reading

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Citations

Aug 9, 2013·Critical Care : the Official Journal of the Critical Care Forum·Sheng WangXiangyu Zhang
Jan 8, 2016·Critical Care : the Official Journal of the Critical Care Forum·Lee-Anne S ChappleDaren K Heyland
Aug 27, 2014·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Beth TaylorLaura Byham-Gray
Sep 25, 2014·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Andréa Maria Cordeiro Ventura, Dan L Waitzberg
Feb 4, 2016·JPEN. Journal of Parenteral and Enteral Nutrition·Charles Chin Han LewMichelle Miller

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