Adequação energética e proteica de pacientes em terapia nutricional enteral internados em uma Unidade de Terapia Intensiva

Pereira, Diego Jorge; Wady, Maria Thereza Baptista; Velarde, Luis Guillermo Coca

Introdução: A adequação nutricional é uma terapêutica que pode diminuir as complicações e melhorar o resultado do tratamento do paciente na Unidade de Terapia Intensiva. Método: Estudo de coorte retrospectivo, sendo os dados obtidos nas fichas de pacientes atendidos entre agosto de 2013 e outubro de 2014, em uso exclusivo de nutrição enteral.

Foram coletados:

diagnóstico principal; uso de drogas vasoativas; dependência de ventilação mecânica e de hemodiálise; exames bioquímicos; dados antropométricos; dia do início e aportes energéticos e proteicos nos 3o e 7o dias suporte nutricional; motivos para o atraso na introdução e evolução do suporte e desfecho clínico (óbito ou alta). Foram obtidos também os déficits energéticos e proteicos cumulativos. Os dados foram analisados com o programa SPSS versão 18.0 por meio da estatística descritiva, sendo significativos os valores de p<0,05.

Resultados:

Foram obtidos dados de 74 pacientes. O tempo de início da terapia nutricional esteve de acordo com o preconizado. Somente as recomendações energéticas foram atingidas dentro do prazo estabelecido. O déficit calórico diário foi menor do que o relatado pela literatura, já para a proteína foi elevado. Os principais fatores que dificul- taram a adequação nutricional foram os relacionados às causas internas. A adequação energética não influenciou nos parâmetros bioquímicos, nem no desfecho da internação dos pacientes. Já os pacientes que atingiram a quota proteica apresentaram menores valores de leucócitos no desfecho e também houve menor número de óbitos quando comparados aos que não atingiram. Conclusões: A terapia nutricional instituída atendeu às recomendações preconizadas para a adequação energética. A oferta proteica esteve em desacordo com as necessidades estimadas.(AU)

Introduction:

The nutritional adequacy is a therapy that can reduce complications and improve the outcome of patient care in the Intensive Care Unit.

Methods:

Retrospective cohort study, the data were obtained from patient records attended from August 2013 to October 2014, in exclusive use of nutrition enteral.

There were collected:

primary diagnosis; vasoactive drugs; dependence on mechanical ventilation and hemodialysis; biochemical tests; anthropometric data; day of start and energy and protein intakes at 3 and 7 days nutritional support; reasons for the delay in the introduction and evolution of support and clinical outcome (death or discharge). Also there were obtained cumulative energy and protein deficits. Data were analyzed with SPSS version 18.0 software using descriptive statistics, being significant p values <0,05.

Results:

It was obtained data from 74 patients. The onset of nutritional therapy time agreed with the recommendations. Only energy recommendations were reached within established. Daily calorie deficit was lower than that reported in the literature, as for the protein was high. The main factors that hampered the nutritional adequacy were related causes interns. An adequate energy intake did not influence the biochemical parameters, or the outcome of the hospitalization of patients. Patients that reached the quota protein had lower leukocyte values in outcome and also fewer deaths when compared to those that not reached.

Conclusions:

Nutritional therapy instituted met the recommended recommendations for energy adequacy. The protein supply was at odds with estimated needs.(AU)