Avaliação da adequação dietética e do estado nutricional de pacientes críticos

Abstract

Introduction: The correct management of Enteral Nutritional Therapy (NER) is extremely important in the aid of complications in the Intensive Care environment, so the identification of possible factors that hamper the supply of nutrients is fundamental to improve critical patient care. The objective of this study was to evaluate the nutritional status and the adequacy of the enteral diet of the patients admitted to the Intensive Care Unit at University Hospital. Method: Descriptive and prospective study with 73 patients. The nutritional status was evaluated by anthropometric measures: weight, height, Body Mass Index (BMI), Arm Circumference (CB), Tricipital Cut Fold (DCT) and Calf Circumference (CP) on the first day of hospitalization and after 7 days and adequacy of the prescribed diet in relation to infused for 7 days from the first day of infusion. Continuous data were analyzed by the median, 1st and 3rd quartile, Pearson correlation and Wilcoxon tests. The categorical data were analyzed by the chi-square test. The level of 5% of significance was considered (p <0.05). Results: The majority of the patients were male, elderly, white and with mean age 60.18 ± 18.69 years. It was observed that the anthropometric indices decreased between the first and second evaluation, increased the percentage of low weight (16.4% - 26%) and decreased overweight / obesity (32.9% - 28.8%) and eutrophic (50.7 - 45.2%), but without significant difference. However, when comparing the median (25-75), nutritional status, and energy and protein values of the infused enteral diet, significant differences were observed, a decrease in all anthropometric measures evaluated (p = 0.001) and an increase in diet kcal / day, kcal / kg / day and protein / g / day (p = 0.001). Conclusion: There was worsening of the nutritional status after seven days despite increasing the percentage of diet adequacy.