(402) Nutrition Risk Assessment, Guidelines, and Protocol in the ICU: 5-year Review of Systematic Reviews

Introduction: In the intensive care unit (ICU) setting, patients can experience a shortage of nutrients due to various factors, such as immobilization, prolonged stress, or loss of appetite, and can thus deteriorate clinically. The importance of nutritional status cannot be emphasized enough as it contributes to the overall outcome significantly, including 28-day mortality rates. While clinical practice guidelines (CPGs) exist at broad levels both nationally and internationally and currently scores such as NUTRIC and NRF-2002 exist to help the assessment of nutritional status, a closer scrutiny of the steps of the process and possibly standardization in aiding nutritional support in the critically ill population is necessary.

Methods: The database PubMed Central was used, and the following key terms were searched to collect review articles: “nutrition”, “critically ill”, and “intensive care unit.” Any articles containing the key terms “nutrition”, “critically ill” and “intensive care unit” were used. Filters were applied to limit articles to systematic reviews published in the past five years. While screening abstracts, the exclusion criteria used included articles examining pediatric populations or retracted articles.

Results: After finding a total of 98 articles, all studies were screened, and 26 articles were used in the generation of this review article. 1 was retracted, 13 studied pediatric populations, and the rest were not relevant to the topic at hand. The majority of the types of studies included systematic reviews and meta-analyses, which examined prior randomized control trials (RCTs), prospective and retrospective studies, and overall did not reach a consensus.

Conclusions: The major findings of the review commented on the lack of evidence and harmony behind most recommendations and clinical practice guidelines (CPGs). Prior studies focused on themes including the comparisons of enteral and parenteral nutrition, specific supplements such as fiber for nutritional support, and reviews of currently existing clinical evidence. One study, Cattani et al 2022, described steps in providing nutritional support, including nutrition screening, assessment, intervention, and monitoring, but an applicable and generalizable standardized protocol in the realm of nutritional support has yet to have been studied.