Farmacia Hospitalaria, Hospital Universitario San Cecilio, Granada, Spain.
Farmacia Hospitalaria, Hospital Universitario San Cecilio, Granada, Spain
Eur J Hosp Pharm. 2021 Nov;28(Suppl 2):e62-e65. doi: 10.1136/ejhpharm-2019-002195. Epub 2020 Jun 23.
To assess compliance in a Spanish intensive care unit (ICU) with 8 of the 13 quality indicators of the Spanish Society of Intensive Medicine and Coronary Units (Sociedad Española de Medicina Intensiva y Unidades Coronarias, SEMICyUC) related to nutrition and metabolism in critically ill patients.
The study included all patients over 18 years of age with an ICU stay of >48 hours between January and May 2019. The pharmacist was integrated into the daily activity of the multidisciplinary team of a 20-bed ICU to monitor and carry out the control of the quality indicators of the SEMICyUC. Studied indicators refer to: nutritional risk assessment and nutritional status (three indicators), glycaemic control, calculation of calorie-protein requirements, and use of early enteral nutrition or adequate parenteral nutrition. Compliance with each indicator was measured as the percentage of patients.
110 patients were included and 73 (66.4%) were male. Compliance results were: blood glucose range (90.7%), severe hypoglycaemia (0%), identification of patients at nutritional risk (58.2%) or with possible refeeding syndrome (8.9%), assessment of nutritional status at admission (58.2%), calculation of calorie-protein requirements (77.8%), early enteral nutrition (96.4%), and adequate use of parenteral nutrition (37.8%) CONCLUSION: Compliance with indicators related to glycaemic control and artificial nutrition (enteral and parenteral nutrition) was higher than reference standards, but there is a need to improve compliance with indicators related to nutritional risk and status at ICU admission. The hospital pharmacist integrated into the ICU multidisciplinary team can add value to the nutrition monitoring and quality indicators of the nutritional process of the critical patient, providing safe and effective nutritional therapy to patients.
评估西班牙重症监护病房（ICU）在 13 项与危重患者营养和代谢相关的西班牙重症医学和冠状动脉单位学会（Sociedad Española de Medicina Intensiva y Unidades Coronarias，SEMICyUC）质量指标中 8 项的执行情况。
本研究纳入了 2019 年 1 月至 5 月间 ICU 入住时间超过 48 小时的所有 18 岁以上患者。药剂师被整合到 20 张病床 ICU 的多学科团队日常活动中，以监测和执行 SEMICyUC 的质量指标控制。研究指标涉及：营养风险评估和营养状况（三个指标）、血糖控制、热量-蛋白质需求计算，以及早期肠内营养或适当的肠外营养的使用。每个指标的依从性均以患者百分比表示。
共纳入 110 例患者，其中 73 例（66.4%）为男性。依从性结果如下：血糖范围（90.7%）、严重低血糖（0%）、识别有营养风险（58.2%）或可能发生再喂养综合征（8.9%）的患者、入院时评估营养状况（58.2%）、计算热量-蛋白质需求（77.8%）、早期肠内营养（96.4%），以及适当使用肠外营养（37.8%）。
血糖控制和人工营养（肠内和肠外营养）相关指标的依从性高于参考标准，但需要提高 ICU 入院时与营养风险和状况相关的指标的依从性。整合到 ICU 多学科团队中的医院药剂师可以为危重患者营养监测和营养过程质量指标增加价值，为患者提供安全有效的营养治疗。
