Acute and Critical Care

Original Article

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.

Citations

Citations to this article as recorded by

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
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Journal of Nutrition and Health.2015; 48(3): 211. CrossRef

Case Report

A Case of Wernicke's Encephalopathy in a Postoperative Patient with Parenteral Nutrition and Temporary Oral Feeding: A Case Report: Hannah Lee, Eun Hye Lee, Sang Chul Lee, Hee Pyoung Park; Korean J Crit Care Med. 2010;25(3):186-189.; DOI: https://doi.org/10.4266/kjccm.2010.25.3.186

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Abstract PDF

Wernicke's encephalopathy is an acute neurological disorder, caused by thiamine deficiency, which is clinically characterized by a triad of ophthalmoplegia, ataxia and disturbances of consciousness. Most frequently, the encephalopathy is a consequence of chronic alcoholism, but it may occur in other forms of malnutrition or malabsorption, such as in prolonged parenteral nutrition without the addition of thiamine, total gastrectomy, gastrojejunostomy, severe anorexia or hyperemesis gravidarum. Thiamine requirement increases during critical illness and in chronically depleted patients, and its supplementation may influence the outcome of the disease. We report a case of a 73-year-old man, who presented with recurred colon cancer, who was affected by Wernicke's encephalopathy while undergoing oral feeding and parenteral nutrition. This case suggests that we should be more aware of potential thiamine deficiency in critically ill patients, even those undergoing parenteral nutrition and temporary oral feeding.

Citations

Citations to this article as recorded by

Two Cases of Wernicke's Encephalopathy That Developed during Total Parenteral Nutrition in Colon Cancer Patients Treated with 5-Fluorouracil-based Chemotherapy
Kyung Pyo Cho, Jae Sung Lee, Ji Seok Seong, Yong Moon Woo, Young Jun Cho, Beom Jin Jeong, Jee Hoon Sohn, Su-Jung Kim
The Korean Journal of Gastroenterology.2014; 64(3): 158. CrossRef
Experiences of Wet Beriberi and Wernicke's Encephalopathy Caused by Thiamine Deficiency in Critically Ill Patients
Ji Young Jang, Hongjin Shim, Jae Gil Lee
Korean Journal of Critical Care Medicine.2013; 28(2): 156. CrossRef

Original Article

Analysis of Nutritional Support Status in the Intensive Care Unit: Seong Shin Moon, Hyungsun Lim, Jin Wook Choi, Deok Kyu Kim, Jeong Woo Lee, Seonghoon Ko, Dong Chan Kim; Korean J Crit Care Med. 2009;24(3):129-133.; DOI: https://doi.org/10.4266/kjccm.2009.24.3.129

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Abstract PDF

BACKGROUND
Nutritional support is important in intensive care for critically ill patients in an effort to decrease the mortality and morbidity. This study was conducted to evaluate the propriety of nutritional support and to understand the effect of a nutrition consultationin critically ill patients to assess and analyze nutritional status.
METHODS
Between January and December 2006, patients who were admitted to the intensive care unit (ICU) > or = 7 days and between 20 and 80 years of age were included. Patients transferred to another hospital, patients discharged against medicine advice, and patients with unknown weight were excluded. Two hundred sixty-two patients were enrolled. The demographic data of patients and the state of nutritional support were reviewed by medical records.
RESULTS
Two hundred sixty-two patients stayed in the ICU a mean of 16.0 +/- 9.8 days and received nutrition support for 11.0 +/- 8.4 days. Except 15 patients who did not receivenutritional support, the mean daily calculated caloric requirement of 247 patients was 1,406.2 +/- 253.8 kcal, the mean daily delivered caloric amount was 899.5 +/- 338.7 kcal, and the total delivered/required caloric ratio was 66.4 +/- 28.1%. The total delivered/required caloric ratio of the patients who received a nutritional consultation and the patients who did not receive nutritional consultation were 72.6 +/- 25.8% and 55.9 +/- 33.3%.
CONCLUSIONS
In this study, we identified that critically ill patients received insufficient nutritional support. We recommend continuous monitoring and management for nutritional support by systematic administration of nutritional support teams.

Citations

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Analysis of Current Status and Predisposing Factors for Nutritional Support of Patients in Surgical Intensive Care Unit
Byung Chul Kim, In Kyu Lee, Eun Young Kim
Surgical Metabolism and Nutrition.2016; 7(2): 32. 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
Nutritional Assessment of ICU Inpatients with Tube Feeding
Yu-Jin Kim, Jung-Sook Seo
Journal of the Korean Dietetic Association.2015; 21(1): 11. CrossRef
Nutrition-Related Factors Predicted Pressure Ulcers in Intensive Care Unit Patients*
Ha Nee Lee, Jeong Sook Park
Journal of Korean Academy of Fundamentals of Nursing.2014; 21(4): 413. 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
Nutritional Support, Gastric Residual Volume and Nutritional Status during Enteral Nutrition in Intensive Care Unit Patients
Minju Lee, Jiyeon Kang
Korean Journal of Adult Nursing.2014; 26(6): 621. CrossRef
Development and Evaluation of an Enteral Nutrition Protocol for Dysphagia in Patients with Acute Stroke
Sung-Hee Yoo, So-Sun Kim
Journal of Korean Academy of Nursing.2014; 44(3): 280. 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
Healthcare Professional's Knowledge, Perception and Performance on Early Enteral Nutrition for Critically Ill Patients
Sun Hee Yun, Sun Jung Kim, Eui Geum Oh
Korean Journal of Critical Care Medicine.2012; 27(1): 36. CrossRef
Effects of Nutrition Support Team Services on Outcomes in ICU Patients
Yeon Hwa MO, Jinnie RHEE, Eui-Kyung LEE
YAKUGAKU ZASSHI.2011; 131(12): 1827. CrossRef
Degree of Nutritional Support and Nutritional Status in MICU Patients
Soo Na Chi, Jea Young Ko, Su Ha Lee, Eun Hwa Lim, Kuk Hwan Kown, Mi Seon Yoon, Eun Sook Kim
The Korean Journal of Nutrition.2011; 44(5): 384. CrossRef
Physician Compliance with Tube Feeding Protocol Improves Nutritional and Clinical Outcomes in Acute Lung Injury Patients
Sungwon Na, Hosun Lee, Shin Ok Koh, Ai Soon Park, A Reum Han
The Korean Journal of Critical Care Medicine.2010; 25(3): 136. CrossRef

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