Effect of nutrition support team on 28-day mortality in Korean patients with acute respiratory failure

Background Providing optimal nutrition to patients with acute respiratory failure is difficult because nutritional requirements vary according to disease severity and comorbidities. In 2021, the National Medical Center initiated a protocol for screening upon admission and regular monitoring by a mul...

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Main Authors: Inhan Lee, Junghyun Kim, Mihyun Ku, Yurim Choi, Sohyun Park, Jihyeon Bang, Joohae Kim
Format: Article
Language:English
Published: Korean Society of Critical Care Medicine 2025-05-01
Series:Acute and Critical Care
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Online Access:http://accjournal.org/upload/pdf/acc-003312.pdf
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author Inhan Lee
Junghyun Kim
Mihyun Ku
Yurim Choi
Sohyun Park
Jihyeon Bang
Joohae Kim
author_facet Inhan Lee
Junghyun Kim
Mihyun Ku
Yurim Choi
Sohyun Park
Jihyeon Bang
Joohae Kim
author_sort Inhan Lee
collection DOAJ
description Background Providing optimal nutrition to patients with acute respiratory failure is difficult because nutritional requirements vary according to disease severity and comorbidities. In 2021, the National Medical Center initiated a protocol for screening upon admission and regular monitoring by a multidisciplinary nutritional support team (NST), for all patients in the medical intensive care unit (ICU). This study aimed to evaluate the effects of routine NST monitoring and active intervention on the clinical outcomes of patients with acute respiratory failure. Methods Patients with acute respiratory failure requiring high-flow nasal cannula, non-invasive ventilation, or mechanical ventilation were included. The primary outcome was 28-day mortality after ICU admission. Secondary outcomes included the supplied/target calorie ratio, supplied/target protein ratio on day 7, and complications. Results In total, 152 patients were included in the analysis. The patients were divided into a pre-monitoring (n=96) and post-monitoring groups (n=56). More patients in the post-monitoring group received NST intervention and had earlier initiation of enteral feeding. In survival analysis, 28-day mortality was significantly lower in post-monitoring group (adjusted hazard ratio, 0.42; 95% CI, 0.24–0.74). The ratio of achievement for required calories and protein on day 7 was higher, but not significantly, in the post-monitoring group. No significant differences were observed in the incidence of complications. Conclusions Regular NST monitoring in the ICU could have contributed to a reduced risk of 28-day mortality in critically ill patients with acute respiratory failure.
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spelling doaj-art-47ea87ae1b554240865be18f1455f3da2025-08-20T03:30:44ZengKorean Society of Critical Care MedicineAcute and Critical Care2586-60522586-60602025-05-0140231332110.4266/acc.0033121595Effect of nutrition support team on 28-day mortality in Korean patients with acute respiratory failureInhan Lee0Junghyun Kim1Mihyun Ku2Yurim Choi3Sohyun Park4Jihyeon Bang5Joohae Kim6 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul, Korea Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea Nutrition Support Team, National Medical Center, Seoul, Korea Department of Clinical Nutrition, National Medical Center, Seoul, Korea Department of Pharmacy, National Medical Center, Seoul, Korea Department of Clinical Nutrition, National Medical Center, Seoul, Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul, KoreaBackground Providing optimal nutrition to patients with acute respiratory failure is difficult because nutritional requirements vary according to disease severity and comorbidities. In 2021, the National Medical Center initiated a protocol for screening upon admission and regular monitoring by a multidisciplinary nutritional support team (NST), for all patients in the medical intensive care unit (ICU). This study aimed to evaluate the effects of routine NST monitoring and active intervention on the clinical outcomes of patients with acute respiratory failure. Methods Patients with acute respiratory failure requiring high-flow nasal cannula, non-invasive ventilation, or mechanical ventilation were included. The primary outcome was 28-day mortality after ICU admission. Secondary outcomes included the supplied/target calorie ratio, supplied/target protein ratio on day 7, and complications. Results In total, 152 patients were included in the analysis. The patients were divided into a pre-monitoring (n=96) and post-monitoring groups (n=56). More patients in the post-monitoring group received NST intervention and had earlier initiation of enteral feeding. In survival analysis, 28-day mortality was significantly lower in post-monitoring group (adjusted hazard ratio, 0.42; 95% CI, 0.24–0.74). The ratio of achievement for required calories and protein on day 7 was higher, but not significantly, in the post-monitoring group. No significant differences were observed in the incidence of complications. Conclusions Regular NST monitoring in the ICU could have contributed to a reduced risk of 28-day mortality in critically ill patients with acute respiratory failure.http://accjournal.org/upload/pdf/acc-003312.pdfcritical illnessintensive care unitnutritional supportrespiratory insufficiency
spellingShingle Inhan Lee
Junghyun Kim
Mihyun Ku
Yurim Choi
Sohyun Park
Jihyeon Bang
Joohae Kim
Effect of nutrition support team on 28-day mortality in Korean patients with acute respiratory failure
Acute and Critical Care
critical illness
intensive care unit
nutritional support
respiratory insufficiency
title Effect of nutrition support team on 28-day mortality in Korean patients with acute respiratory failure
title_full Effect of nutrition support team on 28-day mortality in Korean patients with acute respiratory failure
title_fullStr Effect of nutrition support team on 28-day mortality in Korean patients with acute respiratory failure
title_full_unstemmed Effect of nutrition support team on 28-day mortality in Korean patients with acute respiratory failure
title_short Effect of nutrition support team on 28-day mortality in Korean patients with acute respiratory failure
title_sort effect of nutrition support team on 28 day mortality in korean patients with acute respiratory failure
topic critical illness
intensive care unit
nutritional support
respiratory insufficiency
url http://accjournal.org/upload/pdf/acc-003312.pdf
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