Understanding fasting in the intensive care unit: exploring its profile and motivations.

Abstract

Critically ill patients face complex metabolic challenges, resulting in muscle wasting and malnutrition. Nutritional Therapy (NT) is crucial, but prolonged fasting periods are frequent within the Intensive Care Unit (ICU). This is a descriptive cross-sectional study developed in the ICU of a University Hospital. A total of 301 patients of both sexes, admitted to the ICU during the months of March to May 2023, were included. Data collection addressed fasting time, demographic and health variables. Statistical analysis was performed using Stata software version 14, significance level <0.05. The mean age was under 60 years, predominantly male (53.49%). More than 50% were at nutritional risk; approximately 38% were eutrophic. Mechanical ventilation was not necessary for 58.47%. Most common comorbidity: systemic arterial hypertension (44.09%). A quarter arrived at the ICU with previous nutritional therapy. Oral feeding was allowed for 68.77%, with 36.88% receiving nutritional therapy in the first 12 hours. Significant differences were observed between fasting time and the variables, gender (p=0.03), nutritional risk (p<0.001), use of MV (p<0.001), SAH (p=0.011), other comorbidities (p=0.004), assisting team (p<0.001), reason for fasting (p<0.001) and diet after fasting (p<0.001). The results highlight the importance of understanding the factors associated with prolonged fasting in the ICU. Despite the initial data, the need for personalized and interdisciplinary approaches to optimize outcomes, encouraging early NT, is highlighted. More comprehensive studies are essential for a deeper understanding of demographic and health variables and their relationships with fasting in critically ill patients.