[Nutritional parameters in long-stay critical patients]

A study is made of the evolution of the nutritional biochemical parameters, albumin, prealbumin, cholesterol, creatinine index/height and transferrin, as well as the nutrition route, SAPS, APACHE II, chronic age score, and maximum degree of metabolic stress reached, involving all patients requiring artificial nutrition during at least 14 days, admitted to our intensive medicine unit during an 18 months period, with the aim of finding differences between survivors and those who died. The following conclusions were reached: 1) In patients with severe metabolic stress, like those of the present study, artificial nutrition manages to maintain the nutritional parameters within the limits of moderate malnutrition, improving the nitrogenation balance, without achieving its balance not reducing the consumption of lean body mass, represented by the progressive and significant reduction of the ICALT. 2) In our series, the nutritional parameters behave in a notably different manner with regard to the evolution. In survivors, improvements are seen in albumin, cholesterol, and prealbumin, without variations in transferrin, these changes not being seen in those who died, the latter also showing a significant drop in transferrin, and 3) The greater age and poorer prior health status, despite a lower APS, of those who died appears to be the determining factors for the mortality, and probably also for the different evolution of the nutritional parameters for the usual nutritional standards, maybe due to a lower response capacity to stress.