Oliveira Filho Ronaldo Sousa, Ribeiro Lia Mara Kauchi, Caruso Lucia, Lima Patricia Azevedo, Damasceno Náglia Raquel Teixeira, García Soriano Francisco
Intensive Care Unit. Professional Improvement Program. Hospital Nutrition. University Hospital. University of São Paulo. São Paulo, Brazil.
Nutr Hosp. 2016 Sep 20;33(5):563. doi: 10.20960/nh.563.
Quality Indicators for Nutritional Therapy (QINT) allow a practical assessment of nutritional therapy (NT) quality.
To apply and monitor QINT for critically ill patients at nutritional risk.
Cross sectional study including critically ill patients > 18 years old, at nutritional risk, on exclusive enteral (ENT) or parenteral nutritional therapy (PNT) for > 72 hours. After three consecutive years, 9 QINT were applied and monitored. Statistical analysis was performed with SPSS version 17.0.
A total of 145 patients were included, 93 patients were receiving ENT, among then 65% were male and the mean age was 55.7 years (± 17.4); 52 patients were receiving PNT, 67% were male and the mean age was 58.1 years (± 17.4). All patients (ENT and PNT) were nutritionally screened at admission and their energy and protein needs were individually estimated. Only ENT was early initiated, more than 70% of the prescribed ENT volume was infused and there was a reduced withdrawal of enteral feeding tube. The frequency of diarrhea episodes and digestive fasting were not adequate in ENT patients. The proper supply of energy was contemplated only for PNT patients and there was an expressive rate of oral intake recovery in ENT patients.
After three years of research, the percentage of QINT adequacy varied between 55%-77% for ENT and 60%-80% for PNT. The results were only made possible by the efforts of a multidisciplinary team and the continuous re-evaluation of the procedures in order to maintain the nutritional assistance for patients at nutritional risk.
营养治疗质量指标（QINT）有助于对营养治疗（NT）质量进行实际评估。
对有营养风险的危重症患者应用并监测QINT。
横断面研究，纳入年龄大于18岁、有营养风险、接受全肠内营养（ENT）或肠外营养治疗（PNT）超过72小时的危重症患者。连续三年应用并监测9项QINT。使用SPSS 17.0版进行统计分析。
共纳入145例患者，93例接受ENT治疗，其中65%为男性，平均年龄55.7岁（±17.4）；52例接受PNT治疗，67%为男性，平均年龄58.1岁（±17.4）。所有患者（ENT和PNT）入院时均进行了营养筛查，并分别估算了能量和蛋白质需求。仅ENT治疗开始较早，超过70%的规定ENT量被输注，且肠内喂养管拔除减少。ENT患者腹泻发作频率和消化禁食情况不理想。仅对PNT患者考虑了能量的适当供应，ENT患者口服摄入量恢复率较高。
经过三年研究，ENT的QINT充足率在55%-77%之间，PNT在60%-80%之间。只有多学科团队的努力以及对程序的持续重新评估，才能为有营养风险的患者维持营养支持，从而得出这些结果。
