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Original Articles
- Clinical Outcomes of Nutritional Supply in Critically Ill Patients in the Prone Position
- Yeonju Lee, Hyung-Sook Kim, Hyungwook Namgung, Eun Sook Lee, Euni Lee, Young-Jae Cho, Yeon Joo Lee
- J Clin Nutr 2018;10(1):2-8. Published online June 30, 2018
- DOI: https://doi.org/10.15747/jcn.2018.10.1.2
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Abstract
PDF Purpose:
Enteral nutrition is recommended in critically ill patients. On the other hand, the recommendation of nutritional support is limited and often controversial in critically ill patients in the prone position. Therefore, this study evaluated the clinical outcomes of nutritional support in critically ill patients in the prone position.
Methods:
A retrospective evaluation of the electronic medical records was conducted, including adult patients who were in the medical intensive care unit (ICU) in the prone position in Seoul National University Bundang Hospital from May 1, 2015 to June 30, 2017. The patients’ characteristics, nutritional support status while they were in the prone position, mortality in ICU and during hospitalization, ICU length of stay, mechanical ventilation days, and complications, such as ventilator associated pneumonia (VAP) and vomiting were collected.
Results:
In total, 100 patients were included. Of these, 12 received enteral nutrition and parenteral nutrition and 88 received only parenteral nutrition. The groups were similar in terms of age, sex, number of comorbidity, weight, PaO2/FiO2, hours of prone position, Simplified Acute Physiology Score II (SAPS II), Acute Physiologic and Chronic Health Evaluation II (APACHE II) score, and Sequential Organ Failure Assessment (SOFA) score. No differences were observed in ICU mortality (75.0%
vs . 46.6%; P=0.065), hospital mortality (83.3%vs . 58.0%; P=0.081), ICU length of stay (22.2±14.6vs . 18.2±21.2; P=0.128) and mechanical ventilation days (19.3±14.8vs . 14.5±19.1; P=0.098). In addition, there were no differences in the possible complications of the prone position, such as VAP (8.3%vs . 4.5%; P=0.480) and vomiting (8.3%vs . 1.1%; P=0.227).Conclusion:
No significant differences in the clinical outcomes were observed. Further studies will be needed to confirm the way of nutrition support while in the prone position.
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- Clinical Application of Bioelectrical Impedance Analysis and its Phase Angle for Nutritional Assessment of Critically III Patients
- Hyung-Sook Kim, Eun Sook Lee, Yeon Joo Lee, Jae Ho Lee, Choon-Taek Lee, Young-Jae Cho
- J Clin Nutr 2015;7(2):54-61. Published online August 31, 2015
- DOI: https://doi.org/10.15747/jcn.2015.7.2.54
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Abstract
PDF
Purpose:
Phase angle (PA) is objectively determined from resistance and reactance measured by bioelectrical impedance analysis (BIA)−a quick, noninvasive method. The aim of this study was to evaluate the clinical application of PA by BIA for nutritional assessment of critically ill patients.
Methods:
Eighty nine adult patients admitted to a medical intensive care unit (ICU) of a tertiary academic hospital from August 2012 to September 2013 were analyzed. PA values were measured by direct segmental multi-frequency BIA. As traditional nutrition assessment tools, body mass index (BMI), serum albumin levels, total lymphocyte counts, and our hospital’s nutrition screening index (NSI) were also recorded. Correlations between the results of BIA and other traditional parameters were analyzed.
Results:
PA showed correlation with traditional nutritional parameters, including BMI (r=0.479), serum albumin (r=0.347), and NSI score (r=0.483). Patients with PA lower than the median value (3.5°) had significantly lower nutritional status, increased duration of mechanical ventilation (P=0.039), and increased length of ICU stay (P=0.041).
Conclusion:
PA, as a reflection of body cell mass, measured by BIA could be a potentially useful parameter for nutritional assessment in critically ill patients.
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