Factores que afectan a la meta calórica en pacientes de cuidados intensivos con insuficiencia o falla intestinal.

Resumo

Introduction: Intestinal insufficiency and failure are part of gastrointestinal dysfunction and occur in about 60% of patients hospitalized in intensive care, which affects the fulfillment of nutritional goals. Objective: To establish the factors that affect the fulfillment of the caloric goal of nutritional support in intensive care patients with intestinal insufficiency or failure. Methods: The MEDLINE, SCOPUS and COCHRANE databases were consulted, from January 2015 to September 2020, on caloric goal and intestinal insufficiency and failure in critically ill patients. Two investigators conducted the search, applied the selection criteria, extracted the data, and assessed the methodological quality of the studies. A comparison matrix was made for the articles found and its validity was evaluated. Results: The articles evaluated were heterogeneous and included critical patients with different gastrointestinal disorders. The determinants identified as factors that affect caloric goal were: gastric intolerance, post-pyloric nutrition, use of opioids, use of prokinetics, diarrhea, and multidisciplinary team. Conclusions: This review highlights the absence of validated parameters to qualify intestinal insufficiency or failure in critically ill patients. The six identified aspects that affect the fulfillment of the caloric goal should be evaluated prospectively in this population.