Jeong Shin Lee1,2, Ji Eun Kang3, So Hyun Park3, Hye Kyung Jin4, Soo Min Jang5, Sun Ah Kim2, Sandy Jeong Rhie1,2,3,4. 1. Graduate School of Converging Clinical & Public Health, Ewha Womans University, Seoul, Republic of Korea. 2. Department of Pharmacy, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea. 3. Division of Life and Pharmaceutical Sciences Graduate School, Ewha Womans University, Seoul, Republic of Korea. 4. College of Pharmacy, Ewha Womans University, Seoul, Republic of Korea. 5. Department of Pharmacy Practice, Loma Linda University School of Pharmacy, Loma Linda, CA, USA.
Abstract
BACKGROUND: To examine the outcomes of the implementation of a multidisciplinary nutrition support team (NST) that included a pharmacist for critically ill patients in the intensive care unit (ICU). METHODS: Data were retrospectively collected from electronic medical records and compared between the pre-NST group (n = 73) and post-NST group (n = 75). Patients were included if they received enteral or parenteral nutrition support for at least 72 hours in the ICU of an approximately 900-bed, top-tier university medical center. The percentage of goal kcal, the percentage of goal protein, serum albumin level, total lymphocyte count, C-reactive protein, duration of mechanical ventilation use, hospital length of stay (LOS), ICU LOS, and mortality were evaluated. RESULTS: There were significant differences in the percentage of goal kcal (66.9% ± 25.9% vs 86.2% ± 27.5%; P < 0.001) and the percentage of goal protein (67.0% ± 29.9% vs 81.7% ± 30.7%; P < 0.05) between the pre-NST and post-NST groups. A higher percentage of goal kcal was associated with a significant decrease in the ICU LOS (P < 0.05) and hospital LOS (P < 0.05). The percentage of goal kcal was associated with mortality rate (odd ratio, 0.977; 95% confidential interval, 0.959-0.996; P = 0.016). CONCLUSION: Implementation of a multidisciplinary NST service for critically ill patients was associated with higher percentages of goal kcal and goal protein, as well as a shortened duration of mechanical ventilation use. Higher energy supply was associated with a reduced mortality rate.
BACKGROUND: To examine the outcomes of the implementation of a multidisciplinary nutrition support team (NST) that included a pharmacist for critically illpatients in the intensive care unit (ICU). METHODS: Data were retrospectively collected from electronic medical records and compared between the pre-NST group (n = 73) and post-NST group (n = 75). Patients were included if they received enteral or parenteral nutrition support for at least 72 hours in the ICU of an approximately 900-bed, top-tier university medical center. The percentage of goal kcal, the percentage of goal protein, serum albumin level, total lymphocyte count, C-reactive protein, duration of mechanical ventilation use, hospital length of stay (LOS), ICU LOS, and mortality were evaluated. RESULTS: There were significant differences in the percentage of goal kcal (66.9% ± 25.9% vs 86.2% ± 27.5%; P < 0.001) and the percentage of goal protein (67.0% ± 29.9% vs 81.7% ± 30.7%; P < 0.05) between the pre-NST and post-NST groups. A higher percentage of goal kcal was associated with a significant decrease in the ICU LOS (P < 0.05) and hospital LOS (P < 0.05). The percentage of goal kcal was associated with mortality rate (odd ratio, 0.977; 95% confidential interval, 0.959-0.996; P = 0.016). CONCLUSION: Implementation of a multidisciplinary NST service for critically illpatients was associated with higher percentages of goal kcal and goal protein, as well as a shortened duration of mechanical ventilation use. Higher energy supply was associated with a reduced mortality rate.
Keywords:
critical illness; enteral nutrition; intensive care unit; length of stay; mortality; nutrition support; parenteral nutrition; patient care team
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