PP060
NUTRITIONAL SUPPORT IN THE CARDIO-SURGICAL CRITICAL PATIENT: EXPERIENCE OF A SPECIALIZED UNIT IN PATAGONIA, ARGENTINA
M. A. Litta1, A. Schroeder1, J. M. Rodriguez1, M. A. Nuñez2, L. Manera1, A. L. N. Martinuzzi3,*
1Grupo Leben Salud, Cipolltetti, 2NUTRIHOME SA, Neuquén, 3NUTRIHOME SA, BUENOS AIRES, Argentina
Rationale: Cardiac surgery (CS) patients face high malnutrition risk (40–50%). While early enteral nutrition (EEN) is recommended, evidence regarding its impact on mortality in high-severity cardio-surgical patients remains limited.
Methods: An observational cohort study (n=83) was conducted in a reference center in Patagonia, Argentina. Inclusion criteria: adult patients post-CS with ICU stay > 72 hours and mechanical ventilation. EEN was the primary support. A Stepwise Binomial Logistic Regression was performed to identify independent predictors of mortality, adjusting for clinical severity (APACHE-II).
Results: The population showed high severity (mean APACHE-II: 22.54) and significant comorbidity (73.5%with ≥ 2 conditions). EEN was initiated at a mean of 2.39 days. Nutritional goals (>80% of requirements) were achieved in 79.5% of patients within 7 days. Overall mortality was 38.6%. Multivariate analysis (Classification accuracy: 78.3%) identified two independent predictors of mortality. Higher APACHE-II scores significantly increased the risk of death (OR 1.300; p<0.001). Crucially, achieving nutritional goals acted as a potent independent protective factor (OR 0.057; 95% CI 0.011-0.302; p=0.001), reducing the risk of death by 94.3% after adjusting for severity. Time of extracorporeal circulation and comorbidity index were not independent predictors.
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Conclusion: Early attainment of nutritional goals is a major independent predictor of survival in cardio-critical patients. This protective effect persists regardless of initial clinical severity, supporting aggressive early nutritional protocols.
Disclosure of Interest: None declared