Nutritional-risk scoring systems in the intensive care unit
1Clinical nutrition unit, Rigshospitalet University Hospital, Copenhagen, Denmark.
Current Opinion in Clinical Nutrition and Metabolic Care
|February 5, 2014
Summary
Early supplemental parenteral nutrition may improve outcomes for critically ill patients. Severely ill patients requiring mechanical ventilation for over a week may benefit from nutrition support.
Area of Science:
- Critical Care Medicine
- Nutritional Support
- Clinical Trials
Background:
- Developing effective screening tools for nutrition support in intensive care units (ICUs) is crucial.
- Existing tools like Nutritional Risk Screening 2002 (NRS 2002) and Nutrition risk in the critically ill (NUTRIC score) have limitations.
- APACHE II score is not effective in predicting the benefits of nutrition support.
Purpose of the Study:
- To analyze recent randomized trials on nutrition support for ICU patients.
- To identify optimal screening methods for initiating nutrition support.
Main Methods:
- Systematic review of randomized controlled trials.
- Analysis of clinical outcomes, ICU length of stay, and mechanical ventilation duration.
Main Results:
- Four out of five trials on early supplemental parenteral nutrition showed positive clinical outcomes.
- ICU length of stay ranged from 3-17 days, and mechanical ventilation duration ranged from 2-11 days.
- Limitations of current screening tools (NRS 2002, NUTRIC score) were highlighted.
Conclusions:
- Adequate nutrition support is recommended for severely ill patients.
- Patients anticipated to require mechanical ventilation for a week or more in the ICU may benefit significantly.
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