[Implementing a feeding protocol in an adult ICU (NUTSIA): success and pitfalls]

Nutritional support is an essential part of ICU care. Evidence based guidelines have been developed in countries such as Canada, but their implementation is not easy. After analysing our department and observing insufficiencies in nutritional support, a multidisciplinary working group was set up. A nutrition protocol adapted to local constraints was developed, associated with intensive teaching, and further strengthened by the creation of an ICU dietician position. The evolution of indicators enables analysing impact of the protocol on clinical practice: professionals have been sensitized to feeding issues and to detection of patients at risk of underfeeding. Potential difficulties and successes are reported. In a complex setting such as the ICU, presence of a dedicated dietician is required for daily application of a feeding protocol.