Vía oral en el paciente crítico: lo primero en qué pensar
DOI:
https://doi.org/10.35454/rncm.v6n2.484Palabras clave:
Nutrición, Via oral, Paciente críticoResumen
Aunque la mayoría de guías clínicas de nutrición en el paciente críticamente enfermo hablan mayoritariamente de nutrición enteral y parenteral, poca importancia se ha brindado a la principal vía de alimentación en el ser humano: la vía oral. Dicha vía no debe ser tomada a la ligera, por lo que en la presente revisión narrativa se muestran múltiples escenarios de importancia para la evaluación del inicio seguro y suficiencia de la ingesta de alimentos en el adulto críticamente enfermo.
No se debe olvidar la importancia particular que cada individuo le otorga al alimento, que es un vehículo de sensaciones, recuerdos y sentimientos, adicional a la importancia que adquiere la vía oral en la fase de rehabilitación de la condición crítica o poscrítica. En la presente revisión se exploran diferentes condiciones asociadas al inicio de la vía oral en la UCI con el fin de guiar a los clínicos en la toma de decisiones sobre su inicio, en un contexto de igual importancia como el cumplimiento de las metas nutricionales con el fin de atenuar la desnutrición.
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McClave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). J Parenter Enter Nutr. 2016;40(2):159-211. doi: 10.1177/0148607115621863
Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38(1):48-79. doi: 10.1016/j.clnu.2018.08.037
Elke G, Hartl WH, Kreymann KG, Alhazzani W, Calder PC, Casaer MP, et al. Clinical Nutrition in Critical Care Medicine – Guideline of the German Society for Nutritional Medicine (DGEM). Clin Nutr ESPEN. 2019;33:220-275. doi: 10.1016/j.clnesp.2019.05.002
Fadeur M, Preiser JC, Verbrugge AM, Misset B, Rousseau AF. Oral Nutrition during and after Critical Illness: SPICES for Quality of Care! Nutrients. 2020;12(11):3509. doi: 10.3390/nu12113509
Cardenas D, Correia MITD, Ochoa JB, Hardy G, Rodriguez-Ventimilla D, Bermúdez CE, et al. Clinical nutrition and human rights. An international position paper. Clin Nutr. 2021;40(6):4029-4036. doi: 10.1016/j.clnu.2021.02.039
Peterson SJ, Tsai AA, Scala CM, Sowa DC, Sheean PM, Braunschweig CL. Adequacy of Oral Intake in Critically Ill Patients 1 Week after Extubation. J Am Diet Assoc. 2010;110(3):427-433. doi: 10.1016/j.jada.2009.11.020
Jarden RJ, Sutton-Smith L, Boulton C. Oral intake evaluation in patients following critical illness: an ICU cohort study. Nurs Crit Care. 2018;23(4):179-185. doi: 10.1111/nicc.12343
Moisey LL, Pikul J, Keller H, Yeung CYE, Rahman A, Heyland DK, et al. Adequacy of Protein and Energy Intake in Critically Ill Adults Following Liberation From Mechanical Ventilation Is Dependent on Route of Nutrition Delivery. Nutr Clin Pract. 2021;36(1):201-212. doi: 10.1002/ncp.10558
Chapple L, Gan M, Louis R, Yaxley A, Murphy A, Yandell R. Australian Critical Care Nutrition-related outcomes and dietary intake in non e mechanically ventilated critically ill adult patients : A pilot observational descriptive study. Aust Crit Care. 2020;33(3):300-308. doi: 10.1016/j.aucc.2020.02.008
Rougier L, Preiser JC, Fadeur M, Verbrugge AM, Paquot N, Ledoux D, et al. Nutrition During Critical Care: An Audit on Actual Energy and Protein Intakes. J Parenter Enter Nutr. 2021;45(5):951-960. doi: 10.1002/jpen.1962
Ridley EJ, Parke RL, Davies AR, Bailey M, Hodgson C, Deane AM, et al. What Happens to Nutrition Intake in the Post–Intensive Care Unit Hospitalization Period? An Observational Cohort Study in Critically Ill Adults. J Parenter Enter Nutr. 2019;43(1):88-95. doi: 10.1002/jpen.1196
Merriweather JL, Griffith DM, Walsh TS. Appetite during the recovery phase of critical illness: A cohort study. Eur J Clin Nutr. 2018;72(7):986-992. doi: 10.1038/s41430-018-0181-3
Agarwal E, Ferguson M, Banks M, Batterham M, Bauer J, Capra S, et al. Malnutrition and poor food intake are associated with prolonged hospital stay, frequent readmissions, and greater in-hospital mortality: Results from the Nutrition Care Day Survey 2010. Clin Nutr. 2013;32(5):737-745. doi: 10.1016/j.clnu.2012.11.021
Agarwal E, Ferguson M, Banks M, Bauer J, Capra S, Isenring E. Nutritional status and dietary intake of acute care patients: Results from the Nutrition Care Day Survey 2010. Clin Nutr. 2012;31(1):41-47. doi: 10.1016/j.clnu.2011.08.002
Chapple LA, Gan M, Louis R, Yaxley A, Murphy A, Yandell R. Nutrition-related outcomes and dietary intake in non–mechanically ventilated critically ill adult patients: A pilot observational descriptive study. Aust Crit Care. 2020;33(3):300-308. doi: 10.1016/j.aucc.2020.02.008
Nishioka S, Nakahara S, Takasaki M, Shiohama N, Kokura Y, Suzuki T, et al. The concept of aggressive nutrition therapy and clinical indication: A position paper. Clin Nutr ESPEN. 2022;52:322-330. doi: 10.1016/j.clnesp.2022.09.013
Worthington P, Balint J, Bechtold M, Bingham A, Chan LN, Durfee S, et al. When is parenteral nutrition appropriate? J Parenter Enter Nutr. 2017;41(3):324-377. doi: 10.1177/0148607117695251
Miller KR, McClave SA, Kiraly LN, Martindale RG, Benns MV. A tutorial on enteral access in adult patients in the hospitalized setting. J Parenter Enter Nutr. 2014;38(3):282-295. doi: 10.1177/0148607114522487
Massanet PL, Petit L, Louart B, Corne P, Richard C, Preiser JC. Nutrition Rehabilitation in the Intensive Care Unit. J Parenter Enter Nutr. 2015;39(4):391-400. doi: 10.1177/0148607114567901
Pironi L, Arends J, Baxter J, Bozzetti F, Peláez RB, Cuerda C, et al. ESPEN endorsed recommendations: Definition and classification of intestinal failure in adults. Clin Nutr. 2015;34(2):171-180. doi: 10.1016/j.clnu.2014.08.017
Vanhorebeek I, Latronico N, Van den Berghe G. ICU-acquired weakness. Intensive Care Med. 2020;46(4):637-653. doi: 10.1007/s00134-020-05944-4
Zuercher P, Moret CS, Dziewas R, Schefold JC. Dysphagia in the intensive care unit: Epidemiology, mechanisms, and clinical management. Crit Care. 2019;23(1):1-11. doi: 10.1186/s13054-019-2400-2
Wakabayashi H, Sakuma K. Rehabilitation nutrition for sarcopenia with disability: a combination of both rehabilitation and nutrition care management. J Cachexia Sarcopenia Muscle. 2014;5(4):269-277. doi: 10.1007/s13539-014-0162-x
Perren A, Zürcher P, Schefold JC. Clinical Approaches to Assess Post-extubation Dysphagia (PED) in the Critically Ill. Dysphagia. 2019;34(4):475-486. doi: 10.1007/s00455-019-09977-w
Schefold JC, Berger D, Zürcher P, Lensch M, Perren A, Jakob SM, et al. Dysphagia in mechanically ventilated ICU patients (Dynamics): A prospective observational trial. Crit Care Med. 2017;45(12):2061-2069. doi: 10.1097/CCM.0000000000002765
Brodsky MB, Suiter DM, González-Fernández M, Michtalik HJ, Frymark TB, Venediktov R, et al. Screening Accuracy for Aspiration Using Bedside Water Swallow Tests: A Systematic Review and Meta-Analysis. Chest. 2016;150(1):148-163. doi: 10.1016/j.chest.2016.03.059
Zuercher P, Dziewas R, Schefold JC. Dysphagia in the intensive care unit: a (multidisciplinary) call to action. Intensive Care Med. 2020;46(3):554-556. doi: 10.1007/s00134-020-05937-3
Macht M, Wimbish T, Bodine C, Moss M. ICU-acquired swallowing disorders. Crit Care Med. 2013;41(10):2396-2405. doi: 10.1097/CCM.0b013e31829caf33
Zuercher P, Moser M, Waskowski J, Pfortmueller CA, Schefold JC. Dysphagia Post-Extubation Affects Long-Term Mortality in Mixed Adult ICU Patients—Data From a Large Prospective Observational Study With Systematic Dysphagia Screening. Crit Care Explor. 2022;4(6):e0714. doi: 10.1097/cce.0000000000000714
See KC, Peng SY, Phua J, Sum CL, Concepcion J. Nurse-performed screening for postextubation dysphagia: A retrospective cohort study in critically ill medical patients. Crit Care. 2016;20(1):1-8. doi: 10.1186/s13054-016-1507-y
Singer P, Rattanachaiwong S. To eat or to breathe? The answer is both! Nutritional management during noninvasive ventilation. Crit Care. 2018;22(1):18-20. doi: 10.1186/s13054-018-1947-7
Terzi N, Darmon M, Reignier J, Ruckly S, Garrouste-Orgeas M, Lautrette A, et al. Initial nutritional management during noninvasive ventilation and outcomes: A retrospective cohort study. Crit Care. 2017;21(1):1-9. doi: 10.1186/s13054-017-1867-y
Reeves A, White H, Sosnowski K, Tran K, Jones M, Palmer M. Energy and protein intakes of hospitalised patients with acute respiratory failure receiving non-invasive ventilation. Clin Nutr. 2014;33(6):1068-1073. doi: 10.1016/j.clnu.2013.11.012
Kogo M, Nagata K, Morimoto T, Ito J, Sato Y, Teraoka S, et al. Enteral nutrition is a risk factor for airway complications in subjects undergoing noninvasive ventilation for acute respiratory failure. Respir Care. 2017;62(4):459-467. doi: 10.4187/respcare.05003
Leder SB, Siner JM, Bizzarro MJ, McGinley BM, Lefton-Greif MA. Oral Alimentation in Neonatal and Adult Populations Requiring High-Flow Oxygen via Nasal Cannula. Dysphagia. 2016;31(2):154-159. doi: 10.1007/s00455-015-9669-3
Zerbib O, Rattanachaiwong S, Palti N, Kagan I, Singer P. Energy and protein intake in critically ill people with respiratory failure treated by high-flow nasal-cannula oxygenation: An observational study. Nutrition. 2021;84:111117. doi: 10.1016/j.nut.2020.111117
Sbaih N, Hawthorne K, Lutes J, Cavallazzi R. Nutrition Therapy in Non-intubated Patients with Acute Respiratory Failure. Curr Nutr Rep. 2021;10(4):307-316. doi: 10.1007/s13668-021-00367-z
Hoffman MR. Tracheostomies and PEGs: When Are They Really Indicated? Surg Clin North Am. 2019;99(5):955-965. doi: 10.1016/j.suc.2019.06.009
Ambrosino N, Vitacca M. The patient needing prolonged mechanical ventilation: A narrative review. Multidiscip Respir Med. 2018;13(1):1-10. doi: 10.1186/s40248-018-0118-7
Mah JW, Staff II, Fisher SR, Butler KL. Improving decannulation and swallowing function: A comprehensive, multidisciplinary approach to post-tracheostomy care. Respir Care. 2017;62(2):137-143. doi: 10.4187/respcare.04878
Dobak S, Kelly D. Tough Pill to Swallow: Postextubation Dysphagia and Nutrition Impact in the Intensive Care Unit. Nutr Clin Pract. 2021;36(1):80-87. doi: 10.1002/ncp.10602
McGrath BA, Wallace S. The UK National Tracheostomy Safety Project and the role of speech and language therapists. Curr Opin Otolaryngol Head Neck Surg. 2014;22(3):181-187. doi: 10.1097/MOO.0000000000000046
Goff D, Patterson J. Eating and drinking with an inflated tracheostomy cuff: a systematic review of the aspiration risk. Int J Lang Commun Disord. 2019;54(1):30-40. doi: 10.1111/1460-6984.12430
Wallace S, McGowan S, Ginnelly A. Oral feeding in tracheostomy patients – The Royal College of Speech and Language Therapists tracheostomy clinical excellence network responds. J Intensive Care Soc. 2016;17(2):180-181. doi: 10.1177/1751143715610133
Mullender JL, Wheatley EC, Nethercott DR. Oral feed for patients with a tracheostomy: Balancing risks and benefits. J Intensive Care Soc. 2014;15(4):336-339. doi: 10.1177/175114371401500414
Moore FA, Phillips SM, McClain CJ, Patel JJ, Martindale RG. Nutrition Support for Persistent Inflammation, Immunosuppression, and Catabolism Syndrome. Nutr Clin Pract. 2017;32(1_suppl):121S-127S. doi: 10.1177/0884533616687502
Van Zanten ARH, De Waele E, Wischmeyer PE. Nutrition therapy and critical illness: Practical guidance for the icu, post-icu, and long-term convalescence phases. Crit Care. 2019;23(1):1-10. doi: 10.1186/s13054-019-2657-5
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Derechos de autor 2023 Carlos Alfredo Galindo Martín, Monica , Natalia, Laura
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
