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Review Article
- Current Trend of Nutritional Support Treatment Guidelines for Critically Ill Patients
- Yoo Jin Choi, Jae-Myeong Lee
- J Clin Nutr 2017;9(2):38-47. Published online December 31, 2017
- DOI: https://doi.org/10.15747/jcn.2017.9.2.38
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Abstract
PDF Critically ill and injured patients admitted in the intensive care unit have a range of diseases with various severities. Their conditions should be assessed and the patients should receive specialized nutrition therapy depending on their condition. Like general intensive care, nutrition therapy is upgraded every few years with revised information to provide more idealized nutrition support. The main guidelines in this review are from the Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN). Their previous 2009 guidelines were revised and published in 2016. This review summarizes the 2016 SCCM/ASPEN guidelines focusing on the changes from the previous 2009 guidelines.
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Original Article
- Effects of Compliance with the Nutrition Support Team in Critically Ill Pediatric Patients
- Soo-Jin Park, Ji-Eun Park, Na-Young Kwon, Jae-Song Kim, Eun-Sun Son, Hyun-Ji Yu, Jae-Yeon Bang, Seung Kim, Ho-Seon Eun
- J Clin Nutr 2016;8(2):51-57. Published online August 31, 2016
- DOI: https://doi.org/10.15747/jcn.2016.8.2.51
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Abstract
PDF
Purpose:
This study performed a comparative evaluation of nutritional condition’s improvement and clinical effects in accordance with the Nutrition Support Team (NST) consultation compliance of critically ill pediatric patients.
Methods:
The medical records of 64 critically ill pediatric patients (2 to 18 years old), who were officially referred to a NST consultant in pediatric intensive care unit from January to August 2015, were reviewed. The patients were divided into 2 groups according to the compliance of NST consultation answers. The total delivered/required caloric and protein ratio, weight, serum total protein, serum albumin, hemoglobin, and hematocrit were compared.
Results:
According to the NST consultation answer, ‘nutrition support increase’ occupied the largest proportion at 38.5%; ‘maintenance’ and ‘decrease’ accounted for 35.7% and 18.2% respectively. The NST compliance group and non-compliance group were 20 and 14 patients, respectively. Although total delivered/required caloric ratio was significantly increased in the NST compliance group (19.7%, P=0.036), there was no significant difference in the NST non-compliance group (5.1%, P=0.692). The total delivered/required protein ratio was increased (15.1%, P=0.163) in the NST compliance group and decreased (?4.7%, P=0.774) in the NST non-compliance group. The NST non-compliance group (?8.6%, P=0.219) was further reduced weight than the NST compliance group (?1.0%, P=0.820). The serum albumin was significantly increased in the NST compliance group (13.1%, P=0.003), but there was no difference in the NST non-compliance group (7.1%, P=0.433).
Conclusion:
Although 56.7% of NST consultations were needed for nutritional interventions, a lower NST compliance (53.8%) is the limit of nutritional support. The NST compliance group was supplied adequately with more calories and protein than before consultation and a more improved nutritional status. Therefore, aggressive NST consultation can help increase the therapeutic effect by improving the nutritional status. This study will form the basis to seek ways to further enhance NST compliance.
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