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Korean J Crit Care Med > Volume 27(3); 2012 > Article
Korean Journal of Critical Care Medicine 2012;27(3): 157-164. doi: https://doi.org/10.4266/kjccm.2012.27.3.157
국내 6개 상급 종합전문병원 중환자실 입원환자의 영양집중지원 실태 조사
이송미ㆍ김선형*ㆍ김윤†ㆍ김은미‡ㆍ백희준§ㆍ이승민∥ㆍ이호선¶ㆍ장철호**ㆍ신증수**
강남세브란스병원 영양팀, *전북대학교병원 영양과, †서울대학교병원 급식영양과, ‡삼성서울병원 영양팀, §한양대학교병원 영양과, ∥성신여자대학교 식품영양학과, ¶세브란스병원 영양팀, **연세대학교 의과대학 마취통증의학과교실
Nutrition Support in the Intensive Care Unit of 6 Korean Tertiary Teaching Hospitals: A National Multicenter Observational Study
Song Mi Lee, Seon Hyeung Kim, Yoon Kim, Eunmee Kim, Hee Joon Baek, Seungmin Lee, Hosun Lee, Chul Ho Chang, Cheung Soo Shin
1Department of Nutrition Services, Gangnam Severance Hospital, Seoul, Korea.
2Department of Nutrition Services, Chonbuk National University Hospital, Jeonju, Korea.
3Department of Food Service and Nutrition Care, Seoul National University Hospital, Seoul, Korea.
4Department of Dietetics, Samsung Medical Center, Seoul, Korea.
5Department of Nutrition Services, Hanyang University Seoul Hospital, Seoul, Korea.
6Department of Food and Nutrition, Sungshin Women's University, Seoul, Korea.
7Department of Nutrition and Dietetics, Severance Hospital, Seoul, Korea.
8Department of Anethesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. cheung56@yuhs.ac
ABSTRACT
BACKGROUND: Malnutrition is a frequent nutritional problem among ICU patients, and their nutritional status is known to affect clinical prognosis. We conducted this study to examine nutritional status and actual nutrition delivery in the ICU patients and its relations to clinical outcomes. METHODS: This study was a multicenter retrospective observational study based on the medical records of 163 patients admitted to ICU of tertiary teaching hospitals in Korea. We included the patients who were treated with mechanical ventilation for 3 or more days and received enteral or parenteral nutrition. RESULTS: According to albumin and total lymphocyte count levels, 54.6% of the subjects were moderately or severely malnourished. Mean percentage of calorie and protein delivery to estimated needs for 10 days were 55.8 +/- 29.3% and 46.1 +/- 30.1%, respectively. While parenteral nutrition (PN) started at 1.6 +/- 1.4 days after admission, enteral nutrition (EN) did at 3.6 +/- 2.1 days. Days to PN and EN start, the calorie and protein amount via EN or PN were significantly different among 6 hospitals. No clinical outcomes differed by the levels of calorie or protein delivery. In-hospital mortality was significantly higher in the severely malnourished group at admission as compared to the other 2 groups (54.3% vs. 31.2% vs. 27.7%, p < 0.05) CONCLUSIONS: Malnutrition prevalence is high among Korean intensive care unit patients, but current nutritional therapy practice is inconsistent across institutions and far below the international guidelines. Systematic efforts should be made to develop nutritional support guidelines for Korean ICU patients.
Key Words: critical illness; enteral nutrition; intensive care unit; malnutrition; nutrition support; parenteral nutrition
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