Medical nutrition therapy during the first 5 days of critical illness: a retrospective cohort study
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: The aim of this study was to describe the prescription of medical nutrition therapy for critically ill patients who were admitted to an intensive care unit during the first 5 days. METHODS: In an observational, longitudinal, retrospective study conducted at the intensive care unit of a tertiary hospital in Mexico City, adult patients admitted from January to December 2018 and from November 2024 to February 2025 were included. Indications for fasting, the route of medical nutrition therapy (enteral nutrition-parenteral nutrition), caloric and protein intakes, sequential organ failure assessment score and lactate levels, and vasopressor requirements during the 5 days were evaluated. Delay in initiating medical nutrition therapy was defined as initiated after 48 h of intensive care unit admission. RESULTS: 100 critically ill patients were included; aged 53±18.8, and with a median sequential organ failure assessment score of 10 (7-12). The most frequent diagnoses at admission were pulmonary disease and septic shock. On the first day, 98% of patients were fasting, and 25% received high-dose vasopressor therapy (if the norepinephrine equivalent dose >0.3 μg/kg/min). Over 5 days, medical nutrition therapy transitioned progressively, predominantly from fasting through enteral nutrition (45%) and parenteral nutrition (11%). medical nutrition therapy delay in 54 patients and in a multivariate analysis was associated with age (OR 1.04; 95%CI 1.01-1.07), sequential organ failure assessment score (OR 1.20; 95%CI 1.02-1.40), and lactate levels (OR 1.8; 95%CI 1.10-3.00). CONCLUSION: Prescription of medical nutrition therapy in critically ill patients admitted to a intensive care unit during 5 days is dynamic, and in all patients, it is not possible to initiate at 48 h, associated with higher age and illness severity.
Language: English
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7224800616