title: Enteral nutritional therapy in septic patients in the intensive care unit: compliance with nutritional guidelines for critically ill patients.
abstract: OBJECTIVE
  Evaluate the compliance of septic patients' nutritional management with enteral nutrition guidelines for critically ill patients.
  
  
  METHODS
  Prospective cohort study with 92 septic patients, age ≥ 18 years, hospitalized in an intensive care unit, under enteral nutrition, evaluated according to enteral nutrition guidelines for critically ill patients, compliance with caloric and protein goals, and reasons for not starting enteral nutrition early or for discontinuing it. Prognostic scores, length of intensive care unit stay, clinical progression, and nutritional status were also analyzed.
  
  
  RESULTS
  The patients had a mean age of 63.4 ± 15.1 years, were predominantly male, were diagnosed predominantly with septic shock (56.5%), had a mean intensive care unit stay of 11 (7.2 to 18.0) days, had 8.2 ± 4.2 SOFA and 24.1 ± 9.6 APACHE II scores, and had 39.1% mortality. Enteral nutrition was initiated early in 63% of patients. Approximately 50% met the caloric and protein goals on the third day of intensive care unit stay, a percentage that decreased to 30% at day 7. Reasons for the late start of enteral nutrition included gastrointestinal tract complications (35.3%) and hemodynamic instability (32.3%). Clinical procedures were the most frequent reason to discontinue enteral nutrition (44.1%). There was no association between compliance with the guidelines and nutritional status, length of intensive care unit stay, severity, or progression.
  
  
  CONCLUSIONS
  Although the number of septic patients under early enteral nutrition was significant, caloric and protein goals at day 3 of intensive care unit stay were met by only half of them, a percentage that decreased at day 7.
authors.affiliation: Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil. nutri.valeska@hotmail.com
authors.forename: Valeska Fernandes
authors.initials: VF
authors.lastname: Pasinato
authors.forename: Marina Carvalho
authors.initials: MC
authors.lastname: Berbigier
authors.forename: Bibiana de Almeida
authors.initials: Bde A
authors.lastname: Rubin
authors.forename: Kamila
authors.initials: K
authors.lastname: Castro
authors.forename: Rafael Barberena
authors.initials: RB
authors.lastname: Moraes
authors.forename: Ingrid Dalira Schweigert
authors.initials: ID
authors.lastname: Perry
mesh_terms: D000368:Aged; D015331:Cohort Studies; D016638:Critical Illness; D018450:Disease Progression; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D017410:Practice Guidelines as Topic; D011379:Prognosis; D011446:Prospective Studies; D018805:Sepsis / Q000503:physiopathology / Q000628:therapy*; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000503:physiopathology / Q000628:therapy*