الفهرس 
Malnutrition in critically-ill patientOnly 14 pages are availabe for public view
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Abstract
Critically ill patients are a particularly vulnerable group as their physical problems can mean depleted energy reserves and an increase in energy consumption. Critically ill. patients become nutritionally depleted because various disease processes common to ICU, cause changes in substrate metabolism, which lead to, changes in body composition and ultimately relative deficiencies of some nutrients. Nutritional support in the early stages of critical illness may be necessary to lessen these potential adverse effects. The nutritional support should be routinely provided to ICU patients.In the present siudy, our general aim was to evaluate. the nutritional status of critically ill patients and to develop a protocol for their nutritional care, and to evaluate its impact on the nutritional, metabolic, and clinical outcomes. This study was conducted in Critical care unit of Gamal Abdel Nasser Hospital (General Health Insurance). The study designed as preliminary study (cross sectional study) and intervention study (quasi-experimental comparative study)Preliminary study: The study sample included 200 cases (both sex). Every patient on the first or second day from admission was subjected to collection of the following . data through interviewing With the patient or his relatives. Collection of data included personal characteristics, history intake, anthropometric measurements, detection of nutritional deficiency signs, examination for complications, laboratory examinations, and calculation of nutrient intake, nutrient needs, and pereentof adequacy of nutrient intake. Assessment of me practice of current nutritional management, and calculation of PNI were performed. . Intervention study: This study included intervention group and control group. The sample size was. 200cases (both. sex) for each group which were matched for diagnosis, age and sex. A SNP for management of different cases of ICU was prepared and implemented on intervention group for one week. The Control group was . maintained on the routine medical and nutritional care system of the ICU. Main guidelines of nutritional protocol were enteral feeding trial than parenteral, patient underlying pathological condition was taken into consideration, and the protocol aimed at producing an anabolic status for patient. . The intervention study was carried in three steps, which were preparation and implementation of the NP on the’ intervention group, collection of data from’ both . intervention and control groups and evaluation of the impact of the implemented NP by assessing the changes occurring in some parameters after one week as percent of weight’ change, percent of change in MAC, change in clinical and biochemical parameters change in physiological function tests, and change in PNI. Steps of application of nutrition protocol were determination of feeding route and then obtaining an access, assessment of nutritional status and calculation of nutrient requirements, beginning of feeding through the chosen access route, following protocol of oral diet, following protocol of enteral feeding, following protocol of parenteral feeding both central access and peripheral access, monitoring of the patient, and calculation of parenteral electrolytes needs.