Associação da nutrição enteral precoce com desfechos clínicos em pacientes submetidos a cirurgia cardíaca em uma unidade de terapia intensiva cardiovascular
DOI:
https://doi.org/10.35454/rncm.v6n2.502Palavras-chave:
nutrição enteral precoce, cirurgia cardíaca, paciente gravemente doente, ventilação mecânica invasiva, dias de hospitalResumo
Introdução: a nutrição enteral precoce (EEN) é reconhecida como padrão de atenção em pacientes críticos. A EEN em pacientes em pós-operatório de cirurgia cardíaca tem sido pouco estudada.
Objetivo: analisar a associação entre a EEN com desfechos clínicos.
Métodos: coorte retrospectiva de pacientes adultos pós-cirúrgicos na unidade de terapia intensiva (UTI) que necessitaram de ventilação mecânica invasiva (VMI) por mais de 48 horas. Foi avaliada a associação entre a EEN e a mortalidade hospitalar e na UTI, dias em VMI e dias de internação na UTI por meio de testes de regressão logística e linear.
Resultados: foram incluídos 74 pacientes. A mediana de dias de internação na UTI foi menor no grupo com EEN em comparação com o grupo de nutrição enteral tardia [8 (IQR 6 - 14) vs. 18 (7 - 31), p = 0,005, respectivamente], bem como com dias em VMI [4 (3 - 6) vs. 11(5-24), p = 0,000, respectivamente]. A EEN foi associada a uma diminuição na mortalidade hospitalar (OR 0,21; IC 95% 0,07, 0,67; p = 0,009) e na UTI (OR 0,21; IC 95% 0,5, 0,84; p = 0,027), bem como com os dias de Internação hospitalar na UTI (β -8,03; IC95% -13,44, -2,62; p = 0,004) e dias sob VMI (β -11,86; IC 95% -17,97, -5,74; p = 0,000) no modelo ajustado.
Conclusões: em pacientes críticos submetidos a cirurgia cardíaca, a EEN pode estar associada à diminuição da mortalidade hospitalar e na UTI, bem como aos dias de internação na UTI e sob VMI.
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Copyright (c) 2023 Jacob Jonatan Cruz Sánchez, Carla Aguilar, Mario Gabriel Acosta Osuna, Yarima Janin Soto Romero, María de la Luz Tovar Hernández, Gustavo Rojas Velasco
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