Clinical Nutritional Practices among Critically Ill Patients in Intensive Care Units: A Cross-Sectional Study at a Tertiary Care Hospital, Nepal


Authors : Allen Suwal; Sujan Dhakal; Jenny Bajracharya; Sudip Sapkota; Elija Gautam; Salin Dhakal; Nirjana Bajiko; Sita Dhakal

Volume/Issue : Volume 10 - 2025, Issue 4 - April


Google Scholar : https://tinyurl.com/4w87jh38

Scribd : https://tinyurl.com/yc683cb6

DOI : https://doi.org/10.38124/ijisrt/25apr494

Google Scholar

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Note : Google Scholar may take 15 to 20 days to display the article.


Abstract : Background: Proper nutrition is essential for managing critically ill patients in intensive care units (ICUs) and significantly influences their recovery and outcomes. Understanding patient demographics, dietary habits, and effective nutritional strategies is crucial for optimizing care quality in ICU settings.  Objectives: This study aimed to investigate the clinical nutritional practices among critically ill patients in ICUs at Manmohan Memorial Medical College and Teaching Hospital in Kathmandu, Nepal. Specifically, it sought to analyze demographic profiles, dietary habits, types of nutritional support utilized (oral, tube feeding, intravenous), and their associations with health conditions such as Hypertension (HTN), chronic kidney disease (CKD), Chronic Obstructive Pulmonary Disease (COPD), and Diabetes Mellitus (DM).  Methodology: A retrospective and descriptive cross-sectional research design was employed, involving 89 ICU patients selected through purposive sampling. Data were collected from the ICU Diet Prescription Form and Registry 2023. Statistical analyses included descriptive statistics and chi-square tests to assess associations between nutritional variables and health conditions across patient groups.  Result: The study found that most ICU patients were aged 55-74 years (39.3%), with equal gender distribution (50.6% male). Non-vegetarian diets were prevalent (83.1%), and specialized diets (e.g., renal, high-protein) were prescribed based on medical needs. Meal frequency averaged every 3 hours (50.6%), highlighting tailored nutritional care practices. Oral feeding was the predominant nutritional support method (42.7%), followed by tube feeding (32%) and intravenous feeding (19.1%). Significant associations were observed between specific nutritional variables like special diet provided, amount of fluid balance and length of hospital stay, and health conditions (HTN, CKD, COPD, DM), emphasizing the importance of personalized nutrition based on health conditions. COPD patients exhibited longer ICU and hospital stays compared to other conditions.  Conclusion: This study underscores the critical role of personalized nutrition plans tailored to individual patient needs in ICU settings. Implementation of evidence-based nutritional guidelines and multidisciplinary approaches is crucial to enhance patient care and improve clinical outcomes. Future research should focus on refining nutritional protocols and exploring innovative nutritional therapies to further optimize ICU patient management in Nepal and beyond.

Keywords : ICU Patients, Nutritional Support, Dietary Habits, Clinical Outcomes, Personalized Nutrition, Intensive care Management.

References :

  1. Acharya SP, Bhattarai A, Bhattarai B. An audit of an intensive care unit of a tertiary care hospital. J Nepal Med Assoc. 2018;56(212):759-62. doi:10.31729/jnma.3703.
  2. Al-Dorzi HM, Arabi YM. Nutrition support for critically ill patients. JPEN J Parenter Enteral Nutr. 2021;45(S2):S1-S2. doi:10.1002/jpen.2228.
  3. Preiser JC, Arabi YM, Berger MM, Casaer M, McClave S, Montejo-González JC, et al. A guide to enteral nutrition in intensive care units: 10 expert tips for the daily practice. Crit Care. 2021;25(1):424. doi:10.1186/s13054-021-03847-4.
  4. Vallejo KP, Martínez CM, Matos Adames AA, Fuchs-Tarlovsky V, Nogales GCC, Paz RER, et al. Current clinical nutrition practices in critically ill patients in Latin America: a multinational observational study. Crit Care. 2017;21(1):227. doi:10.1186/s13054-017-1805-z .
  5. Garg S, Sunavala JD, Chakravarti S, Sivakumar MN, Banerjee T, Joshi A, et al. Practice guidelines for nutrition in critically ill patients: A relook for Indian scenario. Indian J Crit Care Med. 2018;22(4):263-73. doi:10.4103/ijccm.IJCCM_3_18 .
  6. McClave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2016;40(2):159-211. doi:10.1177/0148607115621863.
  7. Heyland DK, Dhaliwal R, Jiang X, Day AG. Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool. Crit Care. 2011;15(6): R268. doi:10.1186/cc10546.
  8. Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38(1):48-79. doi:10.1016/j.clnu.2018.08.037.
  9. Dhaliwal R, Cahill N, Lemieux M, Heyland DK. The Canadian critical care nutrition guidelines in 2013: an update on current recommendations and implementation strategies. Nutr Clin Pract. 2014;29(1):29-43. doi:10.1177/0884533613510948.

Background: Proper nutrition is essential for managing critically ill patients in intensive care units (ICUs) and significantly influences their recovery and outcomes. Understanding patient demographics, dietary habits, and effective nutritional strategies is crucial for optimizing care quality in ICU settings.  Objectives: This study aimed to investigate the clinical nutritional practices among critically ill patients in ICUs at Manmohan Memorial Medical College and Teaching Hospital in Kathmandu, Nepal. Specifically, it sought to analyze demographic profiles, dietary habits, types of nutritional support utilized (oral, tube feeding, intravenous), and their associations with health conditions such as Hypertension (HTN), chronic kidney disease (CKD), Chronic Obstructive Pulmonary Disease (COPD), and Diabetes Mellitus (DM).  Methodology: A retrospective and descriptive cross-sectional research design was employed, involving 89 ICU patients selected through purposive sampling. Data were collected from the ICU Diet Prescription Form and Registry 2023. Statistical analyses included descriptive statistics and chi-square tests to assess associations between nutritional variables and health conditions across patient groups.  Result: The study found that most ICU patients were aged 55-74 years (39.3%), with equal gender distribution (50.6% male). Non-vegetarian diets were prevalent (83.1%), and specialized diets (e.g., renal, high-protein) were prescribed based on medical needs. Meal frequency averaged every 3 hours (50.6%), highlighting tailored nutritional care practices. Oral feeding was the predominant nutritional support method (42.7%), followed by tube feeding (32%) and intravenous feeding (19.1%). Significant associations were observed between specific nutritional variables like special diet provided, amount of fluid balance and length of hospital stay, and health conditions (HTN, CKD, COPD, DM), emphasizing the importance of personalized nutrition based on health conditions. COPD patients exhibited longer ICU and hospital stays compared to other conditions.  Conclusion: This study underscores the critical role of personalized nutrition plans tailored to individual patient needs in ICU settings. Implementation of evidence-based nutritional guidelines and multidisciplinary approaches is crucial to enhance patient care and improve clinical outcomes. Future research should focus on refining nutritional protocols and exploring innovative nutritional therapies to further optimize ICU patient management in Nepal and beyond.

Keywords : ICU Patients, Nutritional Support, Dietary Habits, Clinical Outcomes, Personalized Nutrition, Intensive care Management.

Never miss an update from Papermashup

Get notified about the latest tutorials and downloads.

Subscribe by Email

Get alerts directly into your inbox after each post and stay updated.
Subscribe
OR

Subscribe by RSS

Add our RSS to your feedreader to get regular updates from us.
Subscribe