Acute and Critical Care

Chul Ho Chang

3 Articles

Nutrition Support in the Intensive Care Unit of 6 Korean Tertiary Teaching Hospitals: A National Multicenter Observational Study: Song Mi Lee, Seon Hyeung Kim, Yoon Kim, Eunmee Kim, Hee Joon Baek, Seungmin Lee, Hosun Lee, Chul Ho Chang, Cheung Soo Shin; Korean J Crit Care Med. 2012;27(3):157-164.; DOI: https://doi.org/10.4266/kjccm.2012.27.3.157

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BACKGROUND
Malnutrition is a frequent nutritional problem among ICU patients, and their nutritional status is known to affect clinical prognosis. We conducted this study to examine nutritional status and actual nutrition delivery in the ICU patients and its relations to clinical outcomes.
METHODS
This study was a multicenter retrospective observational study based on the medical records of 163 patients admitted to ICU of tertiary teaching hospitals in Korea. We included the patients who were treated with mechanical ventilation for 3 or more days and received enteral or parenteral nutrition.
RESULTS
According to albumin and total lymphocyte count levels, 54.6% of the subjects were moderately or severely malnourished. Mean percentage of calorie and protein delivery to estimated needs for 10 days were 55.8 +/- 29.3% and 46.1 +/- 30.1%, respectively. While parenteral nutrition (PN) started at 1.6 +/- 1.4 days after admission, enteral nutrition (EN) did at 3.6 +/- 2.1 days. Days to PN and EN start, the calorie and protein amount via EN or PN were significantly different among 6 hospitals. No clinical outcomes differed by the levels of calorie or protein delivery. In-hospital mortality was significantly higher in the severely malnourished group at admission as compared to the other 2 groups (54.3% vs. 31.2% vs. 27.7%, p < 0.05) CONCLUSIONS: Malnutrition prevalence is high among Korean intensive care unit patients, but current nutritional therapy practice is inconsistent across institutions and far below the international guidelines. Systematic efforts should be made to develop nutritional support guidelines for Korean ICU patients.

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Nutritional Status of Intensive Care Unit Patients According to the Referral to the Nutrition Support Team and Compliance with the Recommendations
Yunjin Sohn, Taisun Hyun
Korean Journal of Community Nutrition.2022; 27(2): 121. CrossRef
Comparison of the nutritional indicators of critically Ill patients on extracorporeal membrane oxygen (ECMO)
Nah-Mee Shin, Suk Yeon Ha, Yoon Soo Cho
Journal of Nutrition and Health.2021; 54(5): 489. CrossRef
The impact of multidisciplinary nutritional team involvement on nutritional care and outcomes in a medical intensive care unit
H J Jo, D B Shin, B K Koo, E S Ko, H J Yeo, W H Cho
European Journal of Clinical Nutrition.2017; 71(11): 1360. CrossRef
The effect of nutritional supply on clinical outcomes and nutritional status in critically ill patients receiving continuous renal replacement therapy
Ju Yeun Kim, Ji-Myung Kim, Yuri Kim
Journal of Nutrition and Health.2015; 48(3): 211. CrossRef

Effects of APACHE II Score and Initial Nutritional Status on Prognosis of the Critically Ill Patients: Seohui Ahn, Se Hee Na, Chul Ho Chang, Hyunsun Lim, Duk Chul Lee, Cheung Soo Shin; Korean J Crit Care Med. 2012;27(2):102-107.; DOI: https://doi.org/10.4266/kjccm.2012.27.2.102

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Abstract PDF

BACKGROUND
Malnutrition is common in hospitalized patients, especially in critically ill patients and affects their mortality and morbidity. However, the correlation between malnutrition and poor outcome is not fully understood. Our hypothesis is that the nutritional effect on the patient's prognosis would differ depending on the severity of the disease.
METHODS
3,758 patients admitted to the intensive care unit (ICU) were observed retrospectively. Patients were divided into well, moderate and severe groups, according to their nutritional status as assessed by their serum albumin level and total lymphocyte count (TLC). The severity of the disease was assessed by the Acute Physiologic and Chronic Health Evaluation (APACHE II score). All patients were followed clinically until discharge or death and ICU days, hospital days, ventilator days, and mortality rates were recorded.
RESULTS
Depending on the definition used, the prevalence of hospital malnutrition is reported to be 68.3%. Hospital days, ICU days, as well as ventilator days of moderate and severe groups were longer than the well group. In patients exhibiting mild severity of disease, moderate and severe malnutrition groups have 3-5 times the mortality rate than the well group.
CONCLUSIONS
Malnutrition affects the prognosis of patients who have an APACHE II score ranging from 4-29 points. Active nutritional support may be more effective for patients with a disease of mild severity.

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Effects of a video-based enteral nutrition education program using QR codes for intensive care unit nurses: a quasi-experimental study
Won Kee Seo, Hyunjung Kim
Journal of Korean Biological Nursing Science.2024; 26(1): 16. CrossRef
The effect of nutritional supply on clinical outcomes and nutritional status in critically ill patients receiving continuous renal replacement therapy
Ju Yeun Kim, Ji-Myung Kim, Yuri Kim
Journal of Nutrition and Health.2015; 48(3): 211. CrossRef
Comparison of nutritional status indicators according to feeding methods in patients with acute stroke
Sanghee Kim, Youngsoon Byeon
Nutritional Neuroscience.2014; 17(3): 138. CrossRef
Clinical Significance of Postoperative Prealbumin and Albumin Levels in Critically Ill Patients who Underwent Emergency Surgery for Acute Peritonitis
Seung Hwan Lee, Ji Young Jang, Jae Gil Lee
Korean Journal of Critical Care Medicine.2013; 28(4): 247. CrossRef
Nutrition Support in the Intensive Care Unit of 6 Korean Tertiary Teaching Hospitals: A National Multicenter Observational Study
Song Mi Lee, Seon Hyeung Kim, Yoon Kim, Eunmee Kim, Hee Joon Baek, Seungmin Lee, Hosun Lee, Chul Ho Chang, Cheung Soo Shin
Korean Journal of Critical Care Medicine.2012; 27(3): 157. CrossRef

Admission Hyperglycemia Aggravates the Prognosis of Critically Ill Patients: Jong Seok Lee, Chul Ho Chang, Yon Hee Shim, Dong Woo Han, Chang Seok Kim, Cheung Soo Shin; Korean J Crit Care Med. 2004;19(2):121-125.

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Abstract PDF: BACKGROUND
Hyperglycemia is a common disease in critically ill patients, even those without diabetes. It has been recognized acute increase of blood glucose level would increase mortality in patients with and without diabetes in vascular disease such as acute myocardial infarct or acute stroke. However, there is not much data about hyperglycemic effects on the prognosis of patients with heterogenous disease in general intensive care unit (ICU). Aim of this study was to evaluate the effects of admission hyperglycemia on prognosis of critically ill patients with heterogenous disease. METHODS: We reviewed medical records of 712 patients admitted general ICU from July, 2000 to March, 2002 in teaching hospital. The patients who were not checked blood glucose level at ICU admission were excluded. We regarded diabetes patients who have been diagnosed diabetes before ICU admission. Hyperglycemia was defined as a fasting glucose level above 140 mg/dl or random glucose level above 200 mg/dl on 2 or more determinations. We measured hospital mortality, ICU stay, and hospital stay as well as blood glucose level. RESULT: Patients mortalities of diabetic hypergylcemia, nondiabetic hyperglycemia, diabetic normoglycemia, and nondiabetic normoglycemia were 17%, 19%, 26% and 10% respectively. CONCLUSIONS: Mortality of diabetic patients regardless of hyperglycemia at admission time and nondiabetic hyperglycemia patients were higher than nondiabetic normoglycemia patients in ICU.

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