Nutritional Audit in Critically Ill Patients and Compliance with Standard Guidelines- An Observational Study

Abstract

Nutritional support is first line of treatment for patients in ICU. The generally accepted objectives of nutritional delivery in critically sick patients are to enhance patient outcome, prevent nutrient shortages, reduce problems related to nutrition supply and offer nutritional therapy appropriate for patient's state.[1] The study was conducted in ICU of Justice K. S Hegde Charitable Hospital, K. S Hegde Medical Academy, Mangaluru, India. 24 h nutrition intake in ICU patients was recorded. Collected data on nutrition provided was then used to calculate intake and recommended values. We also considered the number of patients getting oral and nasogastric feeds and assessed the difference in the amount of nutrition in them. There was total 144 participants. The participants’ daily nutritional need was estimated using the European Society of Parenteral and Enteral Nutrition (ESPEN), American Society for Parenteral and Enteral Nutrition (ASPEN) and Indian Society of Critical Care Medicine (ISCCM) guidelines, The mean energy demand was of 1435.34 kcal, mean actual intake was 630.68 kcal/day deficit of 807.81 kcal/day. The mean protein requirement was 76.84 g/day, but consumed mean protein was 28.39 g/day with deficit of 48.48g/day. The mean fat requirement was 78.37 g/day, but actual consumed mean fat was 16 g/day with deficit of 62.37g/day. Difference between actual intake of macronutrients and recommended intake of macronutrients by standard guidelines was found, which was pointing towards an insufficient diet being consumed by patients. This iatrogenic malnutrition, if continued for a longer duration, may lead to malnutrition-related complications in patients in ICU.