Nutrition therapy for critically ill patients across the Asia-Pacific and Middle East regions: A consensus statement.

BACKGROUND & AIMS: Guidance on managing the nutritional requirements of critically ill patients in the intensive care unit (ICU) has been issued by several international bodies. While these guidelines are consulted in ICUs across the Asia-Pacific and Middle East regions, there is little guidance available that is tailored to the unique healthcare environments and demographics across these regions. Furthermore, the lack of consistent data from randomized controlled clinical trials, reliance on expert consensus, and differing recommendations in international guidelines necessitate further expert guidance on regional best practice when providing nutrition therapy for critically ill patients in ICUs in Asia-Pacific and the Middle East. METHODS: The Asia-Pacific and Middle East Working Group on Nutrition in the ICU has identified major areas of uncertainty in clinical practice for healthcare professionals providing nutrition therapy in Asia-Pacific and the Middle East and developed a series of consensus statements to guide nutrition therapy in the ICU in these regions. RESULTS: Accordingly, consensus statements have been provided on nutrition risk assessment and parenteral and enteral feeding strategies in the ICU, monitoring adequacy of, and tolerance to, nutrition in the ICU and institutional processes for nutrition therapy in the ICU. Furthermore, the Working Group has noted areas requiring additional research, including the most appropriate use of hypocaloric feeding in the ICU. CONCLUSIONS: The objective of the Working Group in formulating these statements is to guide healthcare professionals in practicing appropriate clinical nutrition in the ICU, with a focus on improving quality of care, which will translate into improved patient outcomes.

Recommended and actual calorie intake of intensive care unit patients in a private tertiary care hospital in the Philippines.

OBJECTIVES: This study compared the computed nutrient requirements of geriatric patients under critical care with their actual intake within the first 3 d after admission to the intensive care unit (ICU) and determined the percentage of patients who achieved adequate intake. METHODS: Fifty-eight geriatric patients who were admitted to the ICU from September to December 2002 were prospectively enrolled. Recommended and actual calorie intakes per patient were recorded and mean amount of carbohydrate, protein, and fat consumed were calculated. Student's t test was used to compare actual with recommended nutrient intakes. RESULTS: Actual in relation to recommended nutrient intake was inadequate (41.5% on day 1 to 71.7% on day 3 for calories and 21.1% on day 1 to 24.3% on day 3 for protein, P < 0.001). Carbohydrate intake was low (falling from 61.9% on day 1 to 39.8% on day 3, P < 0.001) and fat intake was also low (increasing from 29.4% to 37.9% on day 3, P < 0.001). The percentage of patients who achieved adequate intake was 51.2% on day 1 and increased to 73.2% on day 3. CONCLUSIONS: The intake of geriatric patients in the ICU is low, with differences in actual and recommended intakes. Delivering what is recommended is still a goal to be realized in the ICU setting.