92 CHAPTER 6 ABSTRACT Background: Although an increasing amount of patients survive an admission to the intensive care unit (ICU), many survivors suffer from long-term health deficits and a reduced quality of life. The inability to reach nutritional adequacy during ICU-admission and in the recovery period may limit rehabilitation potential. However, information regarding protein and energy intake and nutritional support in the recovery phase is lacking. Methods: In this prospective cohort study, performed in the main tertiary hospital in the Frisian region in the northern part of the Netherlands, 81 adult patients with a length of stay ICU ≥ 48 hours were included. Dietary intake and feeding strategies, baseline and ICU-characteristics and long-term outcomes, i.e. readmissions and mortality, were collected in the first year of recovery. The proportion of patients reaching nutritional adequacy, the influence of feeding strategies and nutritional support, and factors correlated with protein intake were explored. Results: The majority of patients were unable to achieve protein or energy adequacy, not only in the first week of ICU-admission, but also up to 12-months during the recovery phase. Supplementary feeding was found to increase protein and energy intake throughout the patient journey, i.e. during ICU- admission as well as after discharge. Some patients experienced swallowing and taste issues up to 12-months post-ICU (12% and 9%, resp.), but this was not correlated with a higher number of visits to a registered dietician or speech and language therapist. Conclusions: To our knowledge, this is the first study showing that protein and energy intake is below recommendations in the majority of ICU-survivors in ICU and during the recovery phase. Continuous and improved nutritional care is urgently needed to support patients in reaching nutritional adequacy and improving recovery.
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