[Impact of the guidelines on clinical practice of artificial nutrition in intensive care unit after cardiovascular and thoracic surgery].
OBJECTIVE
To analyze the impact of an artificial nutrition program in post-anaesthesia intensive care unit.


METHODS
Observational study.


METHODS
Patients with length of stay greater than 8 days after cardiovascular and thoracic surgery: Group 1: 34 patients (4-month period in 2000); group 2: 15 patients (2-month period in 2001); group 3: 40 patients (4-month period in 2003). Between these 3 periods, informations of physicians and written protocol in order to improve their nutritional knowledge. After analysis of variance (P<0.05). Newman-Keuls tests to compare themselves each groups.


RESULTS
Anthropometric, demographic and clinical parameters were similar in the 3 groups. Energic intakes were less than 80% of basal energetic expenditures in 33%, 33 and 22% of patient, respectively (NS). Caloric and nitrogen intakes were less than recommended, respectively 19+/-6 (mean+/-SD), 21+/-7 and 21+/-8 kcal/kg/24 h and 102+/-32, 111+/-31 and 92+/-40 mg/kg/24 h (NS). However enteral nutrition was administered in 49, 40 and 100% of patients respectively (P<0.001). The glucid/lipid ratio improved from 0.47 in group 1 up to 0.68 in group 3 (P<0.0001). Vitamins, oligoelements and clinical and biological monitoring of artificial nutrition improved (P<0.001).


CONCLUSIONS
A clinical audit demonstrated an improvement in artificial nutrition parameters but no significant change in others.
Hachemi
M
M
Service d'anesthésie-réanimation, hôpital cardiovasculaire et pneumologique Louis-Pradel, BP Lyon-Montchat, 69394 Lyon cedex 03, France. Mohamed.hachemi@chu-lyon.fr
Attof
Y
Y
Flamens
C
C
Bastien
O
O
Boulétreau
P
P
Chambrier
C
C
Lehot
J-J
JJ
D000368:Aged; D013504:Cardiovascular Surgical Procedures; D003422:Critical Care / Q000592:standards*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D018529:Nutritional Support; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D019616:Thoracic Surgical Procedures