Malnutrition
Conditions
Brief summary
The objective is to increase caloric adequacy in patients who survived critical illness and are admitted to the ward by the use of a pro-active inclusive nutritional strategy including supplemental parenteral and/or enteral nutrition and/or oral nutritional supplements guided by indirect calorimetry. This enables the investigators to address, within a clinical/scientific context, a recently demonstrated but until now relatively neglected 'dark side' of patient care at UZ Brussel, comparable to limited global evidence : iatrogenic malnutrition of ICU survivors. The use of a newly developed clinical pathway and nutrition strategy (oral, enteral and parenteral) led by a single SPoC (Single Point of Contact) for patients surviving intensive care will have a clear objective: to address the nutritional deficit in all patients.
Interventions
OTHERClinical Nutrition
Nutritional care plan implementation, including * A step-up and step-down nutritional protocol guided by caloric and protein ratio * Monitoring plan including daily nutritional intake assessment by a dietician and (para)medical supervision by a nutrition support pharmacist and nurse concerning dysphagia, refeeding syndrome, electrolytes abnormalities and access issues * Indirect calorimetry measurements to assess metabolic needs and body impedance analysis to assess body composition on regular time points * Dedicated and specialized dietician and nurse involvement * Adaptive communication policy (translating to native language) and culturally appropriate food regimens and artificial nutrition.
Sponsors
Universitair Ziekenhuis Brussel
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult ≥ 18 years * ICU stay ≥ 7 days * Ward stay ≥ 3 days * Nutritional therapy not restricted * Heterogeneous diseases
Exclusion criteria
* Patients \< 18 years * ICU \< 7 days * Ward stay \< 3 days * Advanced Care Planning with impact on nutritional therapy * Patients with palliative care * Metabolic derangements such as metabolic diseases * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Nutrition Adequacy | The adequacy will be calculated over the entire ward stay: from date of inclusion till 28 days later or death from any cause, whichever came first. | Increase of caloric adequacy (from 58 to 80%) and protein adequacy (from 52 to 80%) in ICU survivors |
Countries
Belgium
Contacts
Primary ContactZenzi Rosseel, PharmD
Backup ContactLotte Buyle, RD
Outcome results
None listed