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2009, Número 2

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Med Crit 2009; 23 (2)


Impacto del retraso del inicio del apoyo nutricio en la morbimortalidad en la Unidad de Terapia Intensiva

Chávez-Pérez JP, Sánchez-Velázquez LD

Idioma: Español
Referencias bibliográficas: 31
Paginas: 70-75
Archivo PDF: 87.86 Kb.


RESUMEN

Introducción: Los enfermos en estado crítico tienen un catabolismo acelerado que los predispone a complicaciones y mayor mortalidad.
Objetivo: Determinar el impacto que tiene el retraso en el inicio del apoyo nutricio en la morbi-mortalidad de los pacientes críticos.
Diseño: Cohorte prolectiva de doce Unidades de Terapia Intensiva mexicanas.
Pacientes: Se incluyeron 2,792 pacientes adultos.
Método: Se colectaron variables demográficas, APACHE II, Bruselas y NEMS. La población se dividió en dos grupos: Grupo A. Inicio de la nutrición antes de 36 horas del ingreso a UTI. Grupo B. Inicio de nutrición después de 36 horas del ingreso. Análisis estadístico bivariado y multivariado, considerando significativo un valor de p ‹ 0.05.
Resultados: Se observaron diferencias estadísticamente significativas en la estancia, razón de mortalidad estandarizada, comorbilidad adquirida en la UTI y en el empleo de recursos a medida que se retrasó el apoyo nutricio. En el análisis multivariado se observó que el retraso nutricio más allá de 36 horas del ingreso a la UTI, tiene un riesgo de 1.6 veces mayor mortalidad.
Conclusiones: El retraso en el inicio del apoyo nutricio provoca mayores estancias hospitalarias, comorbilidad adquirida en la UTI, empleo de recursos y mortalidad.


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