Medical nutrition therapy during the first 5 days of critical illness: a retrospective cohort study
- 1Servicio de Nutriología Clínica del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Unidad de Terapia Intensiva – Mexico City, Mexico.
- 2Servicios Públicos de Salud del Instituto Mexicano del Seguro Social para el Bienestar, Unidad de Atención a la Salud – Mexico City, Mexico.
Abstract
SUMMARY: 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.
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BibTeX
@article{vazquez2026medical,
title = {{Medical nutrition therapy during the first 5 days of critical illness: a retrospective cohort study}},
author = {Aranza Michelle Sánchez Vázquez and Lilia Castillo-Martínez and Eduardo Rivero-Sigarroa and José Ángel Baltazar-Torres and María Fernanda Bernal-Ceballos and José Luis Villanueva-Juárez},
journal = {Revista da Associacao Medica Brasileira (1992)},
year = {2026},
month = oct,
doi = {10.1590/1806-9282.20260939},
url = {https://europepmc.org/article/PMC/PMC13722089},
note = {CC BY},
}
RIS
TY - JOUR
TI - Medical nutrition therapy during the first 5 days of critical illness: a retrospective cohort study
AU - Aranza Michelle Sánchez Vázquez
AU - Lilia Castillo-Martínez
AU - Eduardo Rivero-Sigarroa
AU - José Ángel Baltazar-Torres
AU - María Fernanda Bernal-Ceballos
AU - José Luis Villanueva-Juárez
PY - 2026
DA - 2026/10/30
JO - Revista da Associacao Medica Brasileira (1992)
DO - 10.1590/1806-9282.20260939
UR - https://europepmc.org/article/PMC/PMC13722089
AB - SUMMARY: 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.
SN - 0104-4230
SN - 1806-9282
ER -