Nutrition and Clinical Outcomes of Nutrition Support in Multidisciplinary Team for Critically Ill Patients

Abstract

Background: To examine the outcomes of the implementation of a multidisciplinary nutrition support team (NST) that included a pharmacist for critically ill patients in the intensive care unit (ICU). Methods: Data were retrospectively collected from electronic medical records and compared between the pre-NST group (n = 73) and post-NST group (n = 75). Patients were included if they received enteral or parenteral nutrition support for at least 72 hours in the ICU of an approximately 900-bed, top-tier university medical center. The percentage of goal kcal, the percentage of goal protein, serum albumin level, total lymphocyte count, C-reactive protein, duration of mechanical ventilation use, hospital length of stay (LOS), ICU LOS, and mortality were evaluated. Results: There were significant differences in the percentage of goal kcal (66.9% +/- 25.9% vs 86.2% +/- 27.5%; P < 0.001) and the percentage of goal protein (67.0% +/- 29.9% vs 81.7% +/- 30.7%; P < 0.05) between the pre-NST and post-NST groups. A higher percentage of goal kcal was associated with a significant decrease in the ICU LOS (P < 0.05) and hospital LOS (P < 0.05). The percentage of goal kcal was associated with mortality rate (odd ratio, 0.977; 95% confidential interval, 0.959-0.996; P = 0.016). Conclusion: Implementation of a multidisciplinary NST service for critically ill patients was associated with higher percentages of goal kcal and goal protein, as well as a shortened duration of mechanical ventilation use. Higher energy supply was associated with a reduced mortality rate.