Associação da nutrição enteral precoce com desfechos clínicos em pacientes submetidos a cirurgia cardíaca em uma unidade de terapia intensiva cardiovascular

Autores

  • Carla Gabriela Aguilar-Rodríguez Departamento de Dietética y Nutrición. Instituto Nacional de Cardiología Ignacio Chávez. Tlalpan
  • Mario Gabriel Acosta-Osuna Facultad de Ciencias de la Nutrición y Gastronomía. Universidad Autónoma de Sinaloa. Culiacán
  • Yarima Janin Soto-Romero Departamento de Dietética y Nutrición. Instituto Nacional de Cardiología Ignacio Chávez. Tlalpan
  • Gustavo Rojas-Velasco Unidad de Terapia Intensiva Cardiovascular. Instituto Nacional de Cardiología Ignacio Chávez. Tlalpan
  • María de la Luz Tovar-Hernández Departamento de Dietética y Nutrición. Instituto Nacional de Cardiología Ignacio Chávez. Tlalpan
  • Jacob Jonatan Cruz-Sánchez Instituto Nacional de Cardiología "Ignacio Chávez"

DOI:

https://doi.org/10.35454/rncm.v6n2.502

Palavras-chave:

nutrição enteral precoce, cirurgia cardíaca, paciente gravemente doente, ventilação mecânica invasiva, dias de hospital

Resumo

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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Publicado

2023-05-24

Como Citar

Aguilar-Rodríguez, C. G., Acosta-Osuna, M. G., Soto-Romero, Y. J., Rojas-Velasco, G., Tovar-Hernández, M. de la L., & Cruz-Sánchez, J. J. (2023). Associação da nutrição enteral precoce com desfechos clínicos em pacientes submetidos a cirurgia cardíaca em uma unidade de terapia intensiva cardiovascular. Jornal De Nutrição Clínica E Metabolismo, 6(2), 63–71. https://doi.org/10.35454/rncm.v6n2.502