Bioinformatics assistance of metabolic and nutrition management in the ICU.

PURPOSE OF REVIEW: To review the domains in which computerized information systems have proven beneficial in facilitating the metabolic and nutritional management RECENT
FINDINGS: In glucose control, computerized insulin algorithms have proven safer and more efficient than manual systems, reducing workload, time to target glycemia and numbers of hypoglycemic and hyperglycemic events. By rendering the nutritional variables visible through specific customization, computers do improve daily monitoring of energy balance and adherence to guidelines, particularly for substrate delivery. Nurse-centered systems have shown to be the most successful to enable routine workflow based on protocol-based care.
SUMMARY: Computers are needed to analyze the increasing amount of data collected from critically ill patients from monitoring systems, laboratories and other sources. Studies have shown that computerized information systems do facilitate glucose control, helping reducing hypoglycemic events. They also improve nutritional monitoring (energy delivery and balance, protein and fat delivery), and quality of nutrition. They reduce nurse workload associated with the multiple balance calculations and ease visualization of events out of planned targets. Though integrated systems are expensive, they improve work efficiency.