Abstract

Author(s): Albuquerque Silva, Paola Frassinette de Oliveira1; Alves da Silva, Silvia2; Vasconcelos Petribu, Marina de Moraes2; Xavier do Nascimento, Claudete1; Araújo de Brito, Camilla1

Introduction: The critically ill patient frequently presents hypercatabolism, characterized by elevated energy expenditure and episodes of hyperglycemia. The hyperglycemic state is associated with clinical and nutritional factors and when maintained over a long period increases the risk of mortality.

Objective: To evaluate hyperglycemia and the clinical and nutritional parameters of patients in enteral nutritional therapy, interned at an Intensive Therapy Unit in Recife School hospital.

Methods: Transversal study conducted with in-patients at an Intensive Therapy Unit in enteral support for a minimum period of 48 hours. Clinical data: reason and time of internment, preexisting diabetes, insulin and vasoactive drugs usage, daily capillary glycemy average, start period of nutritional therapy, need for mechanical ventilation, mortality indicators and clinical outcome. Anthropometric data: body mass index, arm and calf circumference. The statistical analysis was taken by Statistical Package for Social Sciences programme version 13.0.

Results: 40 evaluated patients, with an average age of 57,3 ± 17,87. Arm circumference was the nutritional diagnostic parameter with the highest percentage of malnutrition (57.5%). It has been observed significant relation between hyperglycemia and age (p=0,049), preexisting diabetes (p= 0,017), insulin usage (p < 0,001), days of mechanical ventilation (p=0,015) and Sepsis Related Organ Failure Assessment outcome (p=0,011). Mortality was present in 15% of the sample.

Conclusion: Monitoring and glycemic control at the Intensive Therapy Unit is of great relevance, for it can reduce clinical complications that would lead to a minor mortality rate. The usage of glycemic control protocol would be an invaluable tool in this condition.