title: NutritionDay ICU: A 7 year worldwide prevalence study of nutrition practice in intensive care.
abstract: To determine the nutrition practice in intensive care units and the associated outcome across the world, a yearly 1 day cross sectional audit was performed from 2007 to 2013. The data of this initiative called "nutritionDay ICU" were analyzed.
  
  
  
  A questionnaire translated in 17 languages was used to determine the unit's characteristics, patient's condition, nutrition condition and therapy as well as outcome. All the patients present in the morning of the 1 day prevalence study were included from 2007 to 2013.
  
  
  
  9777 patients from 46 countries and 880 units were included. Their SAPS 2 was median 38 (IQR 27-51), predicted mortality was 30.7% ± 26.9, and their SOFA score 4.5 ± 3.4 with median 4 (IQR 2-7). Administration of calories did not appear to be related to actual or ideal body weight within all BMI groups. Patients with a BMI <18.5 or >40 received slightly less calories than all other BMI groups. Two third of the patients were either ventilated or were in the ICU for longer than 24 h at nutritionDay. Routes of feeding used were the oral, enteral and parenteral routes. More than 40% of the patients were not fed during the first day. The mean energy administered using enteral route was 1286 ± 663 kcal/day and using parenteral nutrition 1440 ± 652 kcal/day. 60 days mortality was 26.0%.
  
  
  
  This very large collaborative cohort study shows that most of the patients are underfed during according to actual recommendations their ICU stay. Prescribed calories appear to be ordered regardless to the ideal weight of the patient. Nutritional support is slow to start and never reaches the recommended targets. Parenteral nutrition prescription is increasing during the ICU stay but reaching only 20% of the population studied if ICU stay is one week or longer. The nutritional support worldwide does not seem to be guided by weight or disease but more to be standardized and limited to a certain level of calories. These observations are showing the poor observance to guidelines.
authors.affiliation: Department of Critical Care, Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital and Sackler School of Medicine, Tel Aviv University, 49100, Israel.
authors.forename: Itai
authors.initials: I
authors.lastname: Bendavid
authors.affiliation: Department of Critical Care, Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital and Sackler School of Medicine, Tel Aviv University, 49100, Israel. Electronic address: psinger@clalit.org.il.
authors.forename: Pierre
authors.initials: P
authors.lastname: Singer
authors.affiliation: Department of Critical Care, Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital and Sackler School of Medicine, Tel Aviv University, 49100, Israel.
authors.forename: Miriam
authors.initials: M
authors.lastname: Theilla
authors.affiliation: Center for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, 1090 Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Themessl-Huber
authors.affiliation: Center for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, 1090 Vienna, Austria.
authors.forename: Isabella
authors.initials: I
authors.lastname: Sulz
authors.affiliation: Division of Cardiac Thoracic Vascular Anaesthesia & Intensive Care Medicine, Medical University Vienna, 1090 Vienna, Austria.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Mouhieddine
authors.affiliation: Center for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, 1090 Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Schuh
authors.affiliation: Division of Cardiac Thoracic Vascular Anaesthesia & Intensive Care Medicine, Medical University Vienna, 1090 Vienna, Austria.
authors.forename: Bruno
authors.initials: B
authors.lastname: Mora
authors.affiliation: Division of Cardiac Thoracic Vascular Anaesthesia & Intensive Care Medicine, Medical University Vienna, 1090 Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Hiesmayr
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D002149:Energy Intake; D004750:Enteral Nutrition; D005260:Female; D014943:Global Health; D019538:Health Care Surveys; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D044342:Malnutrition / Q000453:epidemiology / Q000517:prevention & control*; D010288:Parenteral Nutrition; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D062211:Spatio-Temporal Analysis
keywords: Cohort study; Enteral; Intensive care; Nutrition; Oral; Parenteral