title: [Nutritional support response in critically ill patients; differences between medical and surgical patients].
abstract: OBJECTIVE
  To assess the nutritional response of a group of critically ill patients, as well as the differences in the response to nutritional support between medical and surgical patients.
  
  
  METHODS
  One-year long retrospective study including critically ill patients on artificial nutrition for 7 days. Throughout the first week, three nutritional biochemical controls were done that included albumin, prealbumin, transferrin, cholesterol, and electrolytes. Other data gathered were: nutritional risk index, age, gender, weight, height, APACHE, delay of onset of nutritional support, access route, predicted and real caloric intake, medical or surgical patient, hospital stay, duration of the central venous catheter, urinary tube, and/or mechanical ventilation, incidence and density of incidence of nosocomial infections.
  
  
  RESULTS
  Sixty-three patients were studied, 30 (47%) medical and 33 (53%) surgical/trauma patients, with a usage of EN higher among medical patients (16/30, 53% vs. 5/33, 15%), PN higher among surgical patients (25/33, 76%), and mixed nutrition similar in both groups (5 medical and 3 surgical patients) (p = 0.001). There were no differences between medical and surgical patients regarding: both predicted and real caloric and nitrogenous intake, APACHE, delay of onset of nutrition, phosphorus, magnesium or glucose levels, mortality and incidence of nosocomial infections. There were no differences either in hospital stay or use of mechanical ventilation, although these tended to be lower in surgical patients. The baseline biochemical parameters did not show differences between both groups, although they were worse among surgical patients. These patients presented during the study period steady albumin levels with improvement in the remaining parameters, whereas medical patients showed a decrease in albumin and transferrin levels, steady prealbumin levels, and slightly improvement in cholesterol levels.
  
  
  CONCLUSIONS
  We have observed higher usage of PN among surgical patients, which showed worse baseline nutritional biochemical parameters and responded better to nutritional support and having a trend towards shorter hospital stay and lower mechanical ventilation use than medical patients. We have not observed differences regarding the mortality or nosocomial infection.
authors.affiliation: Unidad de Medicina Intensiva, Hospital San Jorge, SALUD, Huesca, España.
authors.forename: M
authors.initials: M
authors.lastname: Zamora Elson
authors.forename: C
authors.initials: C
authors.lastname: Serón Arbeloa
authors.forename: L
authors.initials: L
authors.lastname: Labarta Monzón
authors.forename: I
authors.initials: I
authors.lastname: Garrido Ramírez de Arellano
authors.forename: A
authors.initials: A
authors.lastname: Lander Azcona
authors.forename: M I
authors.initials: MI
authors.lastname: Marquina Lacueva
authors.forename: J C
authors.initials: JC
authors.lastname: López Claver
authors.forename: J
authors.initials: J
authors.lastname: Escós Orta
mesh_terms: D018806:APACHE; D000368:Aged; D003422:Critical Care; D016638:Critical Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009584:Nitrogen / Q000378:metabolism; D018529:Nutritional Support / Q000379:methods*; D010361:Patients; D012189:Retrospective Studies; D012307:Risk Factors; D013514:Surgical Procedures, Operative
chemical_list: D009584:Nitrogen