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ISSN: 2329-6771

Journal of Integrative Oncology
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Research Article

Main Barriers in Control of Energy-Protein Deficit in Critical Oncologic Patient at Nutritional Risk

Ronaldo Sousa Oliveiro Filho1*, Ana Carolina Tamburrino1, Vinícius Somolanji Trevisani2 and Vitor Modesto Rosa2

1Nutritionist, Intensive Care Unit, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil

2Nutritionist, Clinical Coordinator, Service of Nutrition and Dietetics, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil

Corresponding Author:
Ronaldo Sousa Oliveira Filho
Nutritionist, Intensive Care Unit
Instituto do Câncer do Estado de São Paulo
251, Dr Arnaldo Avenue–Cerqueira Cesar
ZIP code: 01246-000 - São Paulo (SP), Brazil
Tel: +55 11 3893 4853
E-mail: [email protected]

Received date: January 18, 2016; Accepted date: February 08, 2016; Published date: February 10, 2016

Citation: Filho RSO, Tamburrino AC, Trevisani VS, Rosa VM (2016) Main Barriers in Control of Energy-Protein Deficit in Critical Oncologic Patient at Nutritional Risk. J Integr Oncol 5:156. doi:10.4172/2329-6771.1000156

Copyright: © 2016 Filho RSO, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction: The Nutrition Risk in Critically ill (NUTRIC) score is a specific tool for assessing the nutritional risk in the Intensive Care Unit (ICU). Under these conditions, it is extremely important to monitor Enteral Nutrition Therapy and identify main barriers in the control of energy-protein deficit.
Objective: To identify main barriers to control the energy-protein deficit in critically ill patients at nutritional risk, on enteral nutrition (EN) and on mechanical ventilation (MV).
Methods: Prospective, observational, descriptive study was conducted in an ICU in 2015. Patients >19 years of age on MV and underwent EN for >72 hours. The data collected were NUTRIC score, Subjective Global Assessment (SGA), Cachexia Syndrome, APACHE II, SOFA, ICU time, MV and EN times and main barriers for pausing EN. The protein-calorie deficit was compiled into total days of EN.
Results: Total of 62 patients, 22 were excluded, 40 analyzed. The scores were NUTRIC 7 (+0.7), APACHE 26 (+5.2), SOFA 11.5 (+2.2), Body Mass Index 23.2 (+6.2) kg/m², 47% malnourished (SGA B+C), 70% cachexia syndrome and mortality rate of 52.5%. Among these patients, 77.5% underwent early EN and percentage of volume prescribed infused was 89%. It was observed total deficit of -296 (+339) calories and -28 (IQ -58:-2.95) g/protein. Main barriers for pausing EN were extubation 38%, hemodynamic instability 29%, tracheostomy, diarrhea and vomiting, both 6.5%. There was a statistically significant difference between calorie (p<0.003) and protein (p<0.002) deficits in the subgroups of adult patients compared to malnourished elderly patients with cachexia syndrome: -358.9 (+305) calories and -33 (+14.24) g/protein; -91.6 (+190) calories and -18.8 (+7.96) g/protein, respectively.
Conclusion: The main barriers in control of energy-protein deficit in critical oncologic patient at nutritional risk on EN and on MV were extubation and hemodynamic instability.

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