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

Objective: To describe the practical aspects of nutritional management in i ntensive care units (ICUs). Design: A 49-item questionnaire was sent to the physician members of the Eu ropean 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 biochemica l (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 t ime the questionnaire was answered were receiving nutritional support; 58 % of those were fed by the enteral route, 23 % by the parenteral route and 1 9% by combined enteral and parenteral. The preferred modality was enteral n utrition, 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 t he practices differed between countries. It was mainly administered as hosp ital-made all-in-one solutions, at a rate based on calculated caloric requi rements. Conclusions: European intensivists are concerned by the nutritional managem ent of their patients. The use of nutritional support is common, essentiall y as early enteral feeding.