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The Latest Insights Into Clinical Nutrition Management From Local Hospital Data

The Screening Day Latin America collected data from 116 hospitals across 8 Latin American countries, receiving insights into clinical nutrition practices and indications for improvement.

The Screening Day Latin America1 brought together ‘United for clinical nutrition’s’ network of physicians and nutrition experts in Latin America to assess the challenges and opportunities of clinical nutrition management, specifically amongst critically ill patients. As a key milestone of the initiative, the Screening Day collected data from a total of 1,053 critically ill adult patients in the intensive care unit (ICU), receiving enteral and/or parenteral nutrition. The results revealed new insights into nutritional management in Latin America.

Read more about the Screening Day background here.

Malnutrition in hospitals in Latin America is highly prevalent

Of the 1,053 patients included, 74 percent had moderate or severe malnutrition1 according to the subjective global assessment (SGA).

Parenteral nutrition produced a decrease in nutritional gaps 

In the study, the 113 patients (10.7 percent) receiving a combination of enteral (EN) and parenteral nutrition (PN) had a 56 percent increased probability of meeting their caloric and protein targets, compared to patients receiving EN alone1.

Only 28.3 percent of these 113 patients had a caloric deficit. This figure is significantly higher than for patients receiving EN only, where 42.4 percent experienced caloric deficits1. The pattern is similar for protein deficits: 36.2 percent of patients receiving a combination of EN and PN experience protein deficits, compared to as many as 50.3 percent of patients receiving EN only, and 37.4 percent in the group receiving PN only1.

Lacking dedicated clinical nutrition teams in ICUs

The Screening Day Latin America not only assessed the individual status of malnutrition, but primary results shed light on resources dedicated to managing clinical nutrition. Only 46 of the total 116 hospitals included reported having a nutrition therapy team in the ICU1. This shows a significant opportunity for ICU units to improve clinical outcomes of critically ill patients by dedicating more resources to carefully planned nutrition, and expertise to use PN where necessary.

Conclusion

PN, when used appropriately, can help to achieve nutritional goals, significantly improve patients’ nutritional status, and support recovery.234 The Screening Day Latin America results show an opportunity to emphasize the benefits of carefully planned nutrition on the recovery of critically ill patients, including PN where required. The low use of PN, coupled with evidence that lower deficits are observed in those receiving some form of PN suggests potential to promote integration of PN into nutrition plans, especially in patients who fail to receive adequate nutrition from EN alone. The data collected provides tangible considerations for clinical nutrition practices and builds awareness of malnutrition in the clinical routine. Read the full results of the screening day here.