Impacto do tipo de terapia nutricional na sobrevida de pacientes críticos desnutridos com hipofosfatemia

• Autor(a) principal: Ribeiro, Amanda Coelho
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFMT
• Texto Completo: http://ri.ufmt.br/handle/1/4398
• topic: Hipofosfatemia; Desnutrição; Síndrome de realimentação; Terapia nutricional; CNPQ::CIENCIAS DA SAUDE::MEDICINA; Hypophosphatemia; Malnourished; Refeeding syndrome; Nutritional therapy

Either prolonged fasting or malnourished critically ill patients usually have hypophosphatemia and are most prone to develop to refeeding syndrome. Objective: To investigate the influence of the type of nutritional therapy (NT) on the survival of critically ill malnourished patients with hypophosphatemia. Method: Retrospective cohort study including 468 patients admitted at the ICU of a tertiary hospital in Cuiabá-MT. It was compared the values of serum phosphorus at admission (P1) and after the initiation of NT (P2) focusing on the frequency of hypophosphatemia (phosphorus <2.5mg / dl) at P1 and P2. The probability of survival in the ICU was investigated according to the type of NT received during hospitalization: enteral nutrition (EN) or EN supplemented nutrition (SEN) in the presence of hypophosphatemia seen at both P1 and P2. The nutritional status was obtained through subjective global assessment. Results: We observed an increased frequency of cases with hypophosphatemia from P1 to P2 in global analysis. However this increase occurred only in patients receiving EN exclusively (p<0.01). The cumulated survival probability was lower for patients with hypophosphatemia who received NE at both P1 (22.4 vs 59.7%, log-rank p=0.001) and P2 (37.4 vs 31.1%, p =0.041 log-rank) when compared to those receiving SEN. Conclusion: SEN increases survival probability over sole EN in malnourished critically with hypophosphatemia.