Critical Care Dietitians' Practices in the Nutritional Management of Critically Ill Patients Receiving Vasopressors and Artificial Nutrition Support

IF 2.3 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics Pub Date : 2026-07-07 DOI:10.1111/jhn.70304

Terpsichori Karpasiti, Qinglin Jin, Kevin Whelan, Danielle Bear

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Abstract

Introduction

Nutritional management of critically ill patients receiving vasopressors is challenging. This survey aimed to describe UK critical care dietitians' practices and confidence regarding the route, timing and dose of artificial nutrition support in critically ill patients receiving vasopressors, and explore relationships of these with intensive care unit (ICU) and dietitian professional characteristics.

Methods

A cross-sectional, anonymous survey was distributed electronically to UK registered dietitians working in ICU via the British Dietetic Association Critical Care Specialist Group and British Society of Parenteral and Enteral Nutrition mailing lists. The 32-item survey included questions regarding ICU and professional characteristics, dietetic practices (artificial nutrition route, timing, and dose), evidence sufficiency and confidence. Data were compared between ICU and professional characteristics and dietetic practice using Fisher's exact or Kruskal-Wallis tests, as appropriate, and with self-reported confidence using Spearman's rank correlation or Kruskal-Wallis.

Results

Of 89 responses, 72 met the eligibility criteria. All respondents completing dietetic practice questions (71/71, 100%) used gastric feeding as the first-line artificial nutrition route, and two thirds (47, 66.2%) initiated this within 24-48 h of ICU admission. Over two thirds (39/57, 68.4%) aimed for < 70% energy targets in the first 72 h, with 48 (84.2%) escalating to full targets thereafter. Despite more than three quarters (41/52, 78.8%) feeling confident in managing critically ill patients receiving vasopressors, most considered evidence to be insufficient. There was no significant association between enteral nutrition practices and any ICU or dietitian professional characteristics or self-reported confidence.

Conclusion

Amongst UK critical care dietitians, there is substantial variation in EN initiation and escalation practices for critically ill patients receiving vasopressors. Despite high self-reported confidence, evidence concerning the route, timing and dose of artificial nutrition was perceived insufficient.

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查看原文本刊更多论文

重症监护营养师在接受血管加压药物和人工营养支持的危重病人营养管理中的实践。

简介：接受血管加压药物治疗的危重患者的营养管理具有挑战性。本调查旨在描述英国重症监护营养师对接受血管加压药物治疗的危重患者人工营养支持的途径、时间和剂量的做法和信心，并探讨这些与重症监护病房（ICU）和营养师专业特征的关系。方法：通过英国饮食协会重症监护专家组和英国肠外和肠内营养学会邮件列表，将横断面匿名调查以电子方式分发给在ICU工作的英国注册营养师。32项调查包括ICU和专业特征、饮食习惯（人工营养途径、时间和剂量）、证据充分性和可信度等问题。采用Fisher’s exact或Kruskal-Wallis检验（视情况而定）比较ICU和专业特征与饮食实践之间的数据，并采用Spearman’s rank correlation或Kruskal-Wallis检验与自我报告的信心进行比较。结果：89份回复中，72份符合资格标准。所有完成饮食实践问题的受访者（71/ 71.100%）均将胃喂养作为一线人工营养途径，三分之二（47.66.2%）在ICU入院后24-48小时内开始进行胃喂养。超过三分之二（39/57,68.4%）的研究旨在得出结论：在英国重症监护营养师中，对于接受血管加压药物治疗的危重患者，在EN启动和升级方面存在很大差异。尽管自我报告的信心很高，但有关人工营养的途径、时间和剂量的证据被认为不足。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Human Nutrition and Dietetics 医学-营养学

CiteScore

5.30

自引率

15.20%

发文量

133

审稿时长

6-12 weeks

期刊介绍： Journal of Human Nutrition and Dietetics is an international peer-reviewed journal publishing papers in applied nutrition and dietetics. Papers are therefore welcomed on: - Clinical nutrition and the practice of therapeutic dietetics - Clinical and professional guidelines - Public health nutrition and nutritional epidemiology - Dietary surveys and dietary assessment methodology - Health promotion and intervention studies and their effectiveness - Obesity, weight control and body composition - Research on psychological determinants of healthy and unhealthy eating behaviour. Focus can for example be on attitudes, brain correlates of food reward processing, social influences, impulsivity, cognitive control, cognitive processes, dieting, psychological treatments. - Appetite, Food intake and nutritional status - Nutrigenomics and molecular nutrition - The journal does not publish animal research The journal is published in an online-only format. No printed issue of this title will be produced but authors will still be able to order offprints of their own articles.