Beneficios de un programa de formación y de un algoritmo clínico de soporte nutricional mixto para mejorar la nutrición del paciente crítico: estudio antes-después.
Por:
Bordejé ML, Juan Díaz M, Crespo M, Ferreruela M and Solano E
Publicada:
10 jun 2021
Ahead of Print:
26 abr 2021
Resumen:
Introduction: optimal nutrition in the critically ill patient is a key aspect for recovery. Objectives: to promote training in and knowledge of mixed nutrition support (MNS) by means of a clinical algorithm among intensivists for improving the nutritional status of critically ill patients. Methods: a before-and-after study with the participation of 19 polyvalent intensive care units (ICUs) in 10 autonomous communities. Five members of the scientific committee trained the trainers by means of oral presentations and a clinical algorithm on MNS. Then, trainers were responsible for explaining the algorithm to local intensivists in their ICUs. The 30-item study questionnaire was completed before and after the intervention by 179 and 105 intensivists, respectively. Results: a clear improvement of knowledge was found in six (20 %) specific MNS-related questions. In 11 items (36.6 %), adequate knowledge on different aspects of nutritional support that were already present before the intervention were maintained, and in five items (16.7 %) an improvement in the rate of correct responses was recorded. There were no improvements in correct responses for four items (13.3 %), and for four (13.3 %) additional items the percentage of correct responses decreased. Conclusions: the use of the MNS algorithm has achieved a solid consolidation of the main concepts of MNS. Some aspects regarding how to manage the malnourished patient, how to identify them and what type of nutrition to guide from the beginning of admission to the ICU, nutritional contributions in special situations, and the monitoring of possible complications such as refeeding are areas for which further training strategies are needed.
Filiaciones:
Bordejé ML:
Servicio de Medicina Intensiva. Hospital Universitari Germans Trias i Pujol. Universitat Autònoma de Barcelona
Juan Díaz M:
Unidad de Medicina Intensiva. Hospital Clínic Universitari de València
:
Servicio de Medicina Intensiva. Hospital Universitario Dr. Peset. ORCID: 0000-0002-8744-918X
Ferreruela M:
Servicio de Medicina Intensiva. Hospital Universitari Son Espases
Solano E:
Servicio de Endocrinología y Nutrición. Hospital Universitari Joan XXIII
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