title: NUTRITION THERAPY IN SEPSIS: CHARACTERIZATION AND IMPLICATIONS FOR CLINICAL PROGNOSIS.
abstract: BACKGROUND
  the inflammatory response caused by sepsis leads to metabolic changes, which may result in significant lean mass loss in septic patient. Because of this, when digestive tract is functional, nutritional therapy (NT) must be initiated within 48 hours of intensive treatment to reduce protein loss.
  
  
  OBJECTIVE
  to evaluate enteral nutritional therapy (ENT) in adult septic patients with exclusive ENT for ≥ 72 hours and length of stay ≥7 days in Intensive Care Unit and its relationship with clinical prognosis.
  
  
  METHODS
  we prospectively analyzed the adequacy of enteral nutrition administered, factors associated with non-conformity, gastrointestinal tolerance and outcome. Statistical tests of chi-square and Student's t as well as Mann-Whitney and Spearman and Pearson correlations (p < 0.05) were used. A multiple logistic regression model has been done by using the stepwise method to evaluate the association between predictors of clinical outcome.
  
  
  RESULTS
  53 patients, 67.9% male and 52.8% elderly were enrolled in this study. The average time for starting ENT was 30 (23.5) hours, and 88.7% of patients achieved nutritional goal in 48 hours. The mean volume delivered in relation to prescribed was 78.9%. When the sample was stratified according to administered/ prescribed calories, patients who received < 80% had a higher mortality rate (p = 0.001) and the caloric intake ≥ 80% was the determining factor in patients' clinical prognosis (p = 0.021).
  
  
  CONCLUSIONS
  septic patients received early enteral nutrition. The nutritional goal and the mean volume delivered in relation to the prescribed volume meet the intensive care guidelines. The nutritional support was associated with clinical outcome, and caloric intake ≥ 80% determining the clinical prognosis. The pauses caused by reflux were significant in the group of patients who died and it may be related to disease severity.
authors: Professional Training Program in Hospital Nutrition of the University Hospital (HU), University of São Paulo - USP - São Paulo (SP).. raquelrcmachado@gmail.com.
authors: Raquel Rodrigues Campos
authors: RR
authors: Machado
authors: Nutritionist of the Nutrition and Dietetics Service at HU- USP - SP (Brazil). Coordinator of Professional Training Program in Hospital Nutrition.. snd@hu.usp.br.
authors: Lúcia
authors: L
authors: Caruso
authors: Graduate Program in Human Nutrition, PRONUT, University of São Paulo - São Paulo (SP).. snd@hu.usp.br.
authors: Patricia de Azevedo
authors: Pde A
authors: Lima
authors: Director of Nutrition and Dietetics Division- HU- USP. Professor of FSP- USP- SP.. snd@hu.usp.br.
authors: Nágila Raquel Teixeira
authors: NR
authors: Damasceno
authors: Head of Adult Intensive Care Unit in HUUSP. Professor, School of Medicine -USP -SP. Research place University Hospital (HU), University of São Paulo - USP - São Paulo SP (Brazil).. snd@hu.usp.br.
authors: Francisco Garcia
authors: FG
authors: Soriano
mesh_terms: D000328:Adult; D000368:Aged; D003422:Critical Care; D002149:Energy Intake; D004750:Enteral Nutrition; D005260:Female; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D044623:Nutrition Therapy / Q000379:methods; D016017:Odds Ratio; D011379:Prognosis; D018805:Sepsis / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome