Survey on clinical nutrition in critical care in Latin America

Abstract

Introduction: Multiple prospective randomized clinical trials in critical care nutrition have conclusively demonstrated that it is unnecessary (and even unadvisable) to meet caloric goals during the first week in the ICU. Instead, it is important to slowly ramp up to meet approximately 1.3 g/k/d in protein delivery by day 5-7. These paradigm changes are now reflected in new international guidelines. 

Objectives: To evaluate the current practices in critical care nutrition in Latin America, with particular emphasis on identifying adoption of new guidelines. 

Methods: An electronic interview was designed in google forms and disseminated through the different nutrition societies in Latin America, targeting clinicians who focused their practice on critical care nutrition. 

Results: A Total of 172 interviews were completed. The majority of clinicians interviewed had over 10 years’ experience in working with critically ill patients. Most clinicians stated that they had changed their clinical practices to reduce their focus on achieving caloric goals while improving protein intake. The majority of clinicians expressed their belief that medical nutrition therapy during the first 7 days in the ICU was associated with improved outcomes. The majority of clinicians still used volume-based feeding with the aim of meeting nutritional goals by this method. 

Conclusions: New guidelines on nutrition in critical care have been partially adopted by clinicians. This work allows us to better understand how to assist clinicians in moving away from old paradigms and embracing new ideas and concepts in their clinical practice.