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2005, Number 2

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Cir Gen 2005; 27 (2)

Repercussion of optimal nutritional support on the cost and mortality in critically ill patients

Terrazas EF, Galindo NA, Sánchez MVM

Language: Spanish
References: 30
Page: 130-136
PDF size: 72.95 Kb.


ABSTRACT

Introduction:Inadequate caloric prescription because of overnutrition affects patients in critical state, lengthening hospital stay due to increase in ventilator use. Undernutrition does not assure energy-caloric needs, lengthening both recovery time and hospital stays.
Objective:Knowing the optimal caloric dose assures quality in the management of critical patients.
Setting:Third level health care hospital.
Patients and methods:Retrospectively, caloric dose of 71 patients in critical sate was compared against resting energy expenditure (REE), measured by indirect calorimetry. Four groups were integrated: group 1 received a caloric dose 25% above REE; group 2 received a caloric dose of 10 – 24% above REE; group 3 received any caloric dose below REE, or up to 9% above it; group 4 included fasting patients.
Results:Linear correlation between caloric dose and hospital stay was R = 0.32 p ‹ 0.006. Hospital stay for each one of the groups was: 23 days for group 1; 14.9 days for group 2; 20.6 days for group 3; and 14.7 days for group 4. Groups 1 and 3 were more expensive, $7,958 and 2,575 USD, per patient in each group, respectively. Group 2 had the lowest mortality (12.5%).
Conclusion:Caloric dose given to patients in group 2 seems to be the optimal dose; since it is cheap, is associated to a low morbidity and shorter hospital stays, when compared to all other three groups.


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