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SPCI - Sociedade Portuguesa de Cuidados Intensivos

Revista Brasileira de Terapia Intensiva

AMIB - Associação de Medicina Intensiva Brasileira

OFFICIAL JOURNAL OF THE ASSOCIAÇÃO BRASILEIRA DE MEDICINA INTENSIVA AND THE SOCIEDADE PORTUGUESA DE CUIDADOS INTENSIVOS

ISSN: 0103-507X
Online ISSN: 1982-4335

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Couto CFL, Dariano Â, Texeira C, Silva CH, Torbes AB, Friedman G. Resposta para: A adequação do suporte nutricional enteral na unidade de terapia intensiva não afeta o prognóstico em curto e longo prazos dos pacientes mecanicamente ventilados: um estudo piloto. Rev Bras Ter Intensiva. 2020;32(4):613

 

 

2020;32(4):613-613
AUTHORS’ RESPONSE

10.5935/0103-507X.20200101

Reply to: Adequacy of enteral nutrition support in intensive care units does not affect the short- and long-term prognosis of mechanically ventilated patients: a pilot study

Resposta para: A adequação do suporte nutricional enteral na unidade de terapia intensiva não afeta o prognóstico em curto e longo prazos dos pacientes mecanicamente ventilados: um estudo piloto

Cecília Flávia Lopes Couto1, Ângela Dariano1, Cassiano Texeira2, Carolina Hauber da Silva3, Anelise Bertotti Torbes3, Gilberto Friedman1

1 Postgraduate Program in Pneumological Sciences, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil.
2 Intensive Care Unit, Hospital Moinhos de Vento - Porto Alegre (RS), Brazil.
3 Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre - Porto Alegre (RS), Brazil.

Corresponding author: Gilberto Friedman, Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul, Rua Fernandes Vieira, 181/601, Zip code: 90035-091 - Porto Alegre (RS), Brazil. E-mail: [email protected]

 

To the Editor

In our study “Adequacy of enteral nutrition support in intensive care units does not affect the short- and long-term prognosis of mechanically ventilated patients: a pilot study”(1) the sample size was calculated to assess the short-term effects, and in this sense, it is not a pilot study. However, we had no information available in the literature, much less in the Brazilian settings about what the sample size would be for a long-term study. Thus, it was considered a pilot study, which allowed us to estimate the magnitude of losses and deaths and to calculate the sample.(2))

The absence of data about what was effectively offered is the limitation. The patients were separated into two different groups (≥ 70% versus < 70%) of calorie intake adequacy considering only the records of what was prescribed, which constitutes information that can be recovered in medical records. In the hospital where the study was conducted, unfortunately, there is no record of what was effectively offered or, better yet, what was delivered. This is a common limitation in this type of study. The progression of the enteral diet is registered in medical records, but sometimes the offer is less (for example pause for a tomography).

The lack of evaluation of the functional capacity at the intensive care unit (ICU) admission is an important limitation. Even so, it is reasonable to speculate that patients who recover over time do so by nutritional adequacy or by tolerance to diet progression - the latter indicating that they would be less severe already in the ICU.

The inference is speculative. The sample size does not allow definitive conclusions, and the article makes this clear from the title. The title (“a pilot study”) is a clear message that the information will eventually be used in planning a larger study.

We appreciate the considerations and take them all as pertinent. We hope we have clarified the main ones.

REFERENCES

Couto CF, Dariano A, Texeira C, Silva CH, Torbes AB, Friedman G. A adequação do suporte nutricional enteral na unidade de terapia intensiva não afeta o prognóstico em curto e longo prazos dos pacientes mecanicamente ventilados: um estudo piloto. Rev Bras Ter Intensiva. 2019;31(1):34-8.
Thabane L, Ma J, Chu R, Cheng J, Ismaila A, Rios LP, et al. A tutorial on pilot studies: the what, why and how. BMC Med Res Methodol. 2010;10:1. Link DOI

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