Josephine M Dudzik, Ethan K Balk, Andrea L Deierlein
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引用次数: 0
Abstract
Background & aims: Many survivors of critical illness experience long-term functional, cognitive, and psychological impairments known as post-intensive care syndrome (PICS). Yet, the nutritional recovery experiences of intensive care unit (ICU) survivors after hospital discharge remain underrecognized and poorly understood. The objective of this review was to characterize nutritional indices and nutrition-related outcomes in survivors of critical illness, and to understand the nutritional recovery experience after hospital discharge.
Methods: Searches were conducted for eligible quantitative and qualitative studies between June and August 2024 using PubMed, CINAHL Complete, and Scopus electronic databases. Abstracts and full texts were screened against predetermined inclusion and exclusion criteria. Primary research analyzing anthropometric, nutritional, and/or experiential data of adult survivors of critical illness after hospital discharge were included in this review.
Results: 21 quantitative (n=3054) and 7 qualitative (n=162) studies were included. After hospital discharge, ICU survivors seldom returned to their baseline weight with many having small to modest weight gains in the first months of recovery. Average calorie (18-33.5 calories/kilogram/day) and protein (0.96-1.6 grams/kilogram/day) intakes largely did not meet requirements needed to facilitate recovery, resulting in high rates of malnutrition, ranging from 16.8-63% 3 months after discharge. A multitude of barriers to nutritional recovery were faced in the post-discharge period resulting from persistent physical and functional limitations due to critical illness. Ongoing individualized nutrition monitoring and follow-up from dietetic professionals knowledgeable in post-ICU care has the potential to improve nutrition-related outcomes for survivors yet remains underutilized. Improving the availability and affordability of such services is a key facilitator to improve the nutritional recovery experience for ICU survivors.
Conclusions: After hospital discharge, many survivors of critical illness face numerous barriers to nutritional recovery resulting in long-term nutritional complications. Future research efforts should target nutritional characterization, associations between nutritional variables and PICS, and the identification and development of effective nutrition interventions to improve long-term outcomes for survivors of critical illness after hospital discharge.
期刊介绍：
Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.
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