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Published on: November 30, 2022
[Relationship between the NUTRIC nutritional risk scale and protein hypercatabolism in critically ventilated
Dino Moretti1, Melisa D Ré, Nicolás S Rocchetti
1Unidad de Cuidados Intensivos. Hospital Escuela "Eva Perón". San Martín 1645. (2152) Granadero Baigorria (Gran Rosario). Santa Fe. Argentina.. morettidino@hotmail.com.
Introduction:
the Nutrition Risk in Critically Ill (NUTRIC) score does not include a variable that objectively estimates protein hypercatabolism (PHC), one of the main metabolic changes experienced by critical patients.
Objective:
to evaluate the correlation of the NUTRIC score with PHC in critically ventilated patients.
Materials And Methods:
prospective, observational study. Mixed ICU. It included ventilated patients ≥ 18 years old, without anuria or chronic renal failure. The modified NUTRIC score, which replaces IL-6 for PCR, was obtained at admission and 24-hour urine was collected at the 2nd (T0) and 4th day (T1) to determine the total urinary nitrogen (TUN).
Results:
a total of 69 patients were included. Average age: 43 years (± 17.01); 73% were males. Admission pathologies: trauma (39%) and sepsis (20%).
Apache Ii:
17 (± 6.66). Seventeen patients presented acute renal failure (ARF). NUTRIC score mean: 3.13 (± 1.94); 84% presented low nutritional risk. The Pearson correlation between NUTRIC and TUN in T0 and T1 was: -0.150 (p: 0.218) and -0.053 (p: 0.663). The mean length of staying in ICU and mechanical ventilation was: 13.35 (± 12.37) and 9.84 (± 10.82) days, respectively. Mortality in ICU: 36%. In the non-ARF subgroup with low risk according to NUTRIC score, 27% presented severe PHC at T0 and 52% at T1. The correlation was: 0.070 (p: 0.620) and 0.138 (p: 0.329), respectively.
Conclusion:
no correlation was found between the estimators of the stress metabolic response of the NUTRIC score and the PHC in critically ill patients ventilated; therefore, it would not be possible to substitute the measurement of the same in the assessment of the nutritional risk.
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