Evaluation of an expert system for enteral nutritional support in critically ill patients with gastrointestinal dysfunction.
DOI:
https://doi.org/10.12873/421trejos-gallegoKeywords:
: biomedical technologies; intestinal failure; intestinal failure; mobile apps; critical care.Abstract
Background: Medicine and nutrition have used computer tools to support decision-making that improves patient care. An expert system is one of these tools that can guide users in handling a specific problem. Adherence to clinical practice guidelines for the nutritional management of patients with gastrointestinal dysfunction optimizes the medical and nutritional treatment of critically ill patients, enabling their recovery. The use of an expert system that facilitates this adherence can improve the clinical outcome of patients.
Objective: To evaluate whether an expert system developed as a tool to improve the adherence of physicians to international guidelines and to support decision-making improves the management of nutritional support in patients with gastrointestinal dysfunction.
Methods: Between June 2020 and January 2021, medical information was collected from critically ill patients with gastrointestinal dysfunction at Hospital Santa Sofía de Caldas. The study consisted of two experimental treatments, one of patients treated with the help of the expert system and the other of patients treated without the help of the expert system, considered as a Control group. Data were collected during the first four months of the study, without the help of the expert system, and in the four subsequent months, nutritional care was supported with the use of the expert system.
Results: There was a statistically significant difference (p = 0.0001) between treatments in the caloric and protein goals variables, and start of enteral nutrition. The patients treated with the help of the expert system presented higher compliance with caloric and protein goals and a shorter start time for enteral nutrition.
Conclusions: the use of the expert system is associated with better adherence to the recommendations of international guidelines, improving tolerance and the provision of enteral nutritional support.
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