Management of nutrition in European intensive care units: results of a questionnaire

Abstract

Objective: To describe the practical aspects of nutritional management in intensive care units (ICUs). Design: A 49-item questionnaire was sent to the physician members of the European Society for Intensive Care Medicine. The issues addressed included: medical environment, assessment of nutritional status and current practice for enteral and parenteral nutrition. Setting: 1608 questionnaires were sent in 35 European countries. Analysis: The answers were pooled and stratified by country. Results: 271 questionnaires were answered (response rate 17 %). Assessment of nutritional status was generally based on clinical (99 %) and biochemical (82 %) parameters rather than on functional (24 %), anthropometric (23 %), immunological (18 %) or questionnaire-based (11 %) data. Two thirds of 2774 patients hospitalised in the corresponding ICUs at the time the questionnaire was answered were receiving nutritional support; 58 % of those were fed by the enteral route, 23 % by the parenteral route and 19 % by combined enteral and parenteral. The preferred modality was enteral nutrition, instituted before the 48th h after admission, at a rate based on estimated caloric requirements. Specific and modified solutions were rarely used. Parenteral nutrition was less commonly used than enteral, although the practices differed between countries. It was mainly administered as hospital-made all-in-one solutions, at a rate based on calculated caloric requirements. Conclusions: European intensivists are concerned by the nutritional management of their patients. The use of nutritional support is common, essentially as early enteral feeding.