[Descriptive analysis of the nutritional support in a polyvalent intensive care unit. Complications of enteral nutrition].
OBJECTIVE
Description of the nutritional support in an intensive care unit. REFERENCE POPULATION: Patients hospitalized in our ICU over a period of 48 months (October 1994-September 1998).


METHODS
The study was carried out by means of a review of the two data bases generated, one by using the clinical history management program, and the other by using the artificial nutrition program.


RESULTS
Nutritional support is used in 31% of the non-coronary patients, predominantly medical (61%), and followed by surgical (29%) and trauma (9%) cases. These patients presented an APACHE (17.7 +/- 15), a hospitalization (15.8 +/- 14.9) and a mortality (26%) that was greater than that in non-coronary patients who did not require the nutritional support. The delay in starting the nutritional support is 2.8 +/- 1.9 days. In decreasing order, the nutritional support is most used in medical (42%), trauma (37%) and surgical (18%) patients. The access route is similar, enteral in 55% of the cases, with a predominance of medical patients, and parenteral in 45% of the cases, with a predominance of surgical patients. In 100 patients with a nutritional support in excess of 10 days, it was found that 87% at some time were given this enterally. In this group we studied the gastrointestinal complications, finding these in 61% of these patients, with the most frequent complication being an increase in the gastric residue (44%). Diarrhea was found in 14% and broncho-aspiration in 3.4%. The enteral route as the initial access failed in 25% of these cases, thus requiring parenteral nutrition.


CONCLUSIONS
In our unit we used nutritional support in 31% of the non coronary patients, and these presented a greater severity, longer hospitalization, and higher mortality than those patients who did not require this. The beginning of the nutritional support is relatively early. The gastrointestinal complications derived from enteral nutrition are very common, with a predominance of gastric retention. In 25% of the critical patients who begin enteral nutrition, this fails, and thus they require parenteral nutrition.
Serón Arbeloa
C
C
Unidad de Medicina Intensiva, Hospital General San Jorge de Huesca.
Avellanas Chavala
M
M
Homs Gimeno
C
C
Larraz Vileta
A
A
Laplaza Marín
J
J
D003327:Coronary Disease; D004750:Enteral Nutrition; D006801:Humans; D007362:Intensive Care Units; D008134:Long-Term Care; D009026:Mortality; D010288:Parenteral Nutrition