Enteral nutrition management in critically ill adult patients and its relationship with intensive care unit-acquired muscle weakness: a national cohort study

Objective: To assess the incidence and determinants of ICU-acquired muscle weakness (ICUAW) in adult patients with enteral nutrition (EN) during the first 7 days in the ICU and mechanical ventilation for at least 48 hours. Methods: A prospective, nationwide, multicentre cohort study in a national IC...

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Autores: Zaragoza-García, Ignacio, Arias-Rivera, Susana, Frade Mera, María Jesús, Martí, Joan Daniel, Gallart, Elisabet, San José-Arribas, Alicia, Velasco-Sanz, Tamara Raquel, Blazquez-Martínez, Eva, Raurell Torredà, Marta
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/201124
Acceso en línea:https://hdl.handle.net/2445/201124
Access Level:acceso abierto
Palabra clave:Nutrició
Unitats de cures intensives
Músculs
Malalts en estat crític
Nutrition
Intensive care units
Muscles
Critically ill
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spelling Enteral nutrition management in critically ill adult patients and its relationship with intensive care unit-acquired muscle weakness: a national cohort studyZaragoza-García, IgnacioArias-Rivera, SusanaFrade Mera, María JesúsMartí, Joan DanielGallart, ElisabetSan José-Arribas, AliciaVelasco-Sanz, Tamara RaquelBlazquez-Martínez, EvaRaurell Torredà, MartaNutricióUnitats de cures intensivesMúsculsMalalts en estat críticNutritionIntensive care unitsMusclesCritically illObjective: To assess the incidence and determinants of ICU-acquired muscle weakness (ICUAW) in adult patients with enteral nutrition (EN) during the first 7 days in the ICU and mechanical ventilation for at least 48 hours. Methods: A prospective, nationwide, multicentre cohort study in a national ICU network of 80 ICUs. ICU patients receiving invasive mechanical ventilation for at least 48 hours and EN the first 7 days of their ICU stay were included. The primary outcome was incidence of ICUAW. The secondary outcome was analysed, during days 3-7 of ICU stay, the relationship between demographic and clinical data to contribute to the onset of ICUAW, identify whether energy and protein intake can contribute independently to the onset of ICUAW and degree of compliance guidelines for EN. Results: 319 patients were studied from 69 ICUs in our country. The incidence of ICUAW was 153/222 (68.9%; 95% CI [62.5%-74.7%]). Patients without ICUAW showed higher levels of active mobility (p = 0.018). The logistic regression analysis showed no effect on energy or protein intake on the onset of ICUAW. Overfeeding was observed on a significant proportion of patient-days, while more overfeeding (as per US guidelines) was found among patients with obesity than those without (42.9% vs 12.5%; p<0.001). Protein intake was deficient (as per US/European guidelines) during ICU days 3-7. Conclusions: The incidence of ICUAW was high in this patient cohort. Early mobility was associated with a lower incidence of ICUAW. Significant overfeeding and deficient protein intake were observed. However, energy and protein intake alone were insufficient to explain ICUAW onset. Relevance to clinical practice: Low mobility, high incidence of ICUAW and low protein intake suggest the need to train, update and involve ICU professionals in nutritional care and the need for early mobilization of ICU patients.Public Library of Science (PLoS)2023202320232023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion14 p.application/pdfhttps://hdl.handle.net/2445/201124Articles publicats en revistes (Infermeria Fonamental i Clínica)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1371/journal.pone.0286598PLoS One, 2023, vol. 18, num. 6, p. e0286598https://doi.org/10.1371/journal.pone.0286598cc-by (c) Zaragoza-García, Ignacio et al., 2023https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/2011242026-05-29T05:05:01Z
dc.title.none.fl_str_mv Enteral nutrition management in critically ill adult patients and its relationship with intensive care unit-acquired muscle weakness: a national cohort study
title Enteral nutrition management in critically ill adult patients and its relationship with intensive care unit-acquired muscle weakness: a national cohort study
spellingShingle Enteral nutrition management in critically ill adult patients and its relationship with intensive care unit-acquired muscle weakness: a national cohort study
Zaragoza-García, Ignacio
Nutrició
Unitats de cures intensives
Músculs
Malalts en estat crític
Nutrition
Intensive care units
Muscles
Critically ill
title_short Enteral nutrition management in critically ill adult patients and its relationship with intensive care unit-acquired muscle weakness: a national cohort study
title_full Enteral nutrition management in critically ill adult patients and its relationship with intensive care unit-acquired muscle weakness: a national cohort study
title_fullStr Enteral nutrition management in critically ill adult patients and its relationship with intensive care unit-acquired muscle weakness: a national cohort study
title_full_unstemmed Enteral nutrition management in critically ill adult patients and its relationship with intensive care unit-acquired muscle weakness: a national cohort study
title_sort Enteral nutrition management in critically ill adult patients and its relationship with intensive care unit-acquired muscle weakness: a national cohort study
dc.creator.none.fl_str_mv Zaragoza-García, Ignacio
Arias-Rivera, Susana
Frade Mera, María Jesús
Martí, Joan Daniel
Gallart, Elisabet
San José-Arribas, Alicia
Velasco-Sanz, Tamara Raquel
Blazquez-Martínez, Eva
Raurell Torredà, Marta
author Zaragoza-García, Ignacio
author_facet Zaragoza-García, Ignacio
Arias-Rivera, Susana
Frade Mera, María Jesús
Martí, Joan Daniel
Gallart, Elisabet
San José-Arribas, Alicia
Velasco-Sanz, Tamara Raquel
Blazquez-Martínez, Eva
Raurell Torredà, Marta
author_role author
author2 Arias-Rivera, Susana
Frade Mera, María Jesús
Martí, Joan Daniel
Gallart, Elisabet
San José-Arribas, Alicia
Velasco-Sanz, Tamara Raquel
Blazquez-Martínez, Eva
Raurell Torredà, Marta
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Nutrició
Unitats de cures intensives
Músculs
Malalts en estat crític
Nutrition
Intensive care units
Muscles
Critically ill
topic Nutrició
Unitats de cures intensives
Músculs
Malalts en estat crític
Nutrition
Intensive care units
Muscles
Critically ill
description Objective: To assess the incidence and determinants of ICU-acquired muscle weakness (ICUAW) in adult patients with enteral nutrition (EN) during the first 7 days in the ICU and mechanical ventilation for at least 48 hours. Methods: A prospective, nationwide, multicentre cohort study in a national ICU network of 80 ICUs. ICU patients receiving invasive mechanical ventilation for at least 48 hours and EN the first 7 days of their ICU stay were included. The primary outcome was incidence of ICUAW. The secondary outcome was analysed, during days 3-7 of ICU stay, the relationship between demographic and clinical data to contribute to the onset of ICUAW, identify whether energy and protein intake can contribute independently to the onset of ICUAW and degree of compliance guidelines for EN. Results: 319 patients were studied from 69 ICUs in our country. The incidence of ICUAW was 153/222 (68.9%; 95% CI [62.5%-74.7%]). Patients without ICUAW showed higher levels of active mobility (p = 0.018). The logistic regression analysis showed no effect on energy or protein intake on the onset of ICUAW. Overfeeding was observed on a significant proportion of patient-days, while more overfeeding (as per US guidelines) was found among patients with obesity than those without (42.9% vs 12.5%; p<0.001). Protein intake was deficient (as per US/European guidelines) during ICU days 3-7. Conclusions: The incidence of ICUAW was high in this patient cohort. Early mobility was associated with a lower incidence of ICUAW. Significant overfeeding and deficient protein intake were observed. However, energy and protein intake alone were insufficient to explain ICUAW onset. Relevance to clinical practice: Low mobility, high incidence of ICUAW and low protein intake suggest the need to train, update and involve ICU professionals in nutritional care and the need for early mobilization of ICU patients.
publishDate 2023
dc.date.none.fl_str_mv 2023
2023
2023
2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/201124
url https://hdl.handle.net/2445/201124
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0286598
PLoS One, 2023, vol. 18, num. 6, p. e0286598
https://doi.org/10.1371/journal.pone.0286598
dc.rights.none.fl_str_mv cc-by (c) Zaragoza-García, Ignacio et al., 2023
https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Zaragoza-García, Ignacio et al., 2023
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 14 p.
application/pdf
dc.publisher.none.fl_str_mv Public Library of Science (PLoS)
publisher.none.fl_str_mv Public Library of Science (PLoS)
dc.source.none.fl_str_mv Articles publicats en revistes (Infermeria Fonamental i Clínica)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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