Nutrition in the intensive care unit and early recovery influence functional outcomes for survivors of critical illness: A prospective cohort study

• Published in: JPEN. Journal of parenteral and enteral nutrition Vol. 47; no. 7; p. 888
• Main Authors: Jubina, Lindsey E, Locke, Alleyna, Fedder, Kelly R, Slone, Stacey A, Soper, Melissa K, Kalema, Anna G, Montgomery-Yates, Ashley A, Mayer, Kirby P
• Format: Journal Article
• Language: English
• Published: United States 01.09.2023
• Subjects: Adult; Critical Illness; Humans; Intensive Care Units; Length of Stay; Nutritional Status; Prospective Studies; Survivors; enteral feeding; ICU-acquired weakness; calorie deficit; critical care nutrition; postintensive care syndrome
• ISSN: 1941-2444
• DOI: 10.1002/jpen.2538

Patients who are critically ill may receive suboptimal nutrition that leads to weight loss and increased risk of functional deficits. Our overarching hypothesis is that nutrition in the intensive care unit (ICU) and the early recovery phase associates with functional outcomes at short-term follow-up. We enrolled adult patients who attended the University of Kentucky ICU recovery clinic (ICU-RC) from November 2021 to June 2022. Patients participated in muscle and functional assessments. Nutrition intake and status during the ICU stay were analyzed. The Subjective Global Assessment and a nutrition questionnaire were used to identify changes in intake, ongoing gastrointestinal symptoms, and patient's access to food at the ICU-RC appointment. Forty-one patients enrolled with a median hospital length of stay (LOS) of 23 days. Patients with 0 days of nil per os (NPO) status throughout hospitalization had a shorter LOS (P = 0.05), were able to complete the five times sit-to-stand test (P = 0.02), and were less likely to experience ICU-acquired weakness (P = 0.04) at short-term follow-up compared with patients with ≥1 day of NPO status. Twenty (48%) patients reported changes in nutrition intake in early recovery compared with before hospitalization. Eight (20%) patients reported symptoms leading to decreased intake and four (10%) reported access to food as a barrier to intake. Barriers to nutrition exist during critical illness and persist after discharge, with almost half of patients reporting a change in intake. Inpatient nutrition intake is associated with functional outcomes and warrants further exploration.