[From the creation to the appreciation of a personal digital assistant-based clinical decision-support system for the management of artificial nutrition].
OBJECTIVE
The aim of our study was to assess the effect of NutriPDA, a personal digital assistant (PDA)-based clinical decision-support system (CDSS) for the management of artificial nutrition. A CDSS was developed and implemented on a handheld computer for use in the ICU after cardiovascular and thoracic surgery.


METHODS
System impact was assessed in a prospective "before/after" cohort trial.


METHODS
After informed consent we studied 61 patients in the postcardiovascular and thoracic surgery ICU (age > 17 years, duration of artificial nutrition > 3 days, length of stay > 8 days). Patients were divided into two groups (before and after the use of NutriPDA: Group A: 32 patients (4-month period in 2005); group B: 29 patients (4-month period in 2006).


RESULTS
There were no significant differences in anthropometric and clinical parameters between the 2 groups. Energetic intakes were < 80% of basal energetic expenditures in 21% and 1% of patients, respectively (P < 0.01). Caloric and nitrogen intakes were below international recommendation in Group A: 20+/-4 kcal/kg/d (mean+/-SD), 104+/-30 mg/kg/d, but not in Group B: 26+/-5 kcal/kg/d, 196+/-41 mg/kg/d (P < 0.01).


CONCLUSIONS
NutriPDA was found to be able to optimize artificial nutrition by improving caloric intake in ICU. This new software has potential clinical applications.
Attof
Y
Y
Service d'anesthésie-réanimation, hôpital cardiovasculaire et pneumologique Louis-Pradel, hospices civils de Lyon, BP Lyon-Monchat, 69394 Lyon cedex 03, France; ERI 22, université Claude-Bernard Lyon-I, France. yassin.attof@gmail.com
Hachemi
M
M
Cannesson
M
M
Souza Neto
E-P
EP
Rosamel
P
P
Chambrier
C
C
Bastien
O
O
Lehot
J-J
JJ
D000368:Aged; D034201:Computers, Handheld; D020000:Decision Support Systems, Clinical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018529:Nutritional Support; D011446:Prospective Studies; D012984:Software