SCI: Caloric and Protein Needs in Acute and Rehabilitation Phases (2007)
To review nutrition as a component of acute spinal cord management for the critical care nurse.
None given.
Recruitment
Methods for study inclusion not specified
Design
Narrative review
Blinding used (if applicable)
Not applicable
Intervention (if applicable)
Not applicable
Statistical Analysis
Statistical analysis not performed
Timing of Measurements
Not applicable
Dependent Variables
Not applicable
Independent Variables
Not applicable
Control Variables
Not applicable
Initial N: 46 references cited
Attrition (final N): 46
Age: not applicable
Ethnicity: not applicable
Other relevant demographics: not applicable
Anthropometrics: not applicable
Location: worldwide studies
Formulas for calculating
- energy expenditure from oxygen saturation
- anabolic protein requirement from 24-hour urine nitrogen excretion
Factors affecting nutrition, including:
- Glucose intolerance
- Pressure ulcer
- Anemia
- Respiratory dysfunction
- Ileus
- GI ulcer
- Neurogenic bowel and bladder
- Hypercalcemia
- Depression
- Medication.
Nutritional Assessment-ABCD
- Widely accepted guidelines for weight in SCI: Less than the Metropolitan Life Insurance ideal body weight for a given height and frame
- 10 to 15 lbs. less—paraplegia
- 15-20 lbs. less—quadriplegia.
Prediction of energy needs
- Harris-Benedict x1.5-1.75 for acute and x1.75-2.0 for SCI with multiple trauma
- Also notes that the HB may overestimate actual requirement.
Protein requirement
- 0.8 gm/kg body weight—maintenance
- 1.0 to 1.5 gm/kg with injury, illness or stress
- Calorie-to-nitrogen ratio 150:1 for minimum depletion, and 100:1 for multiple trauma.
University/Hospital: | Baptist Memorial of Memphis |
“Traditional” review article with no description of search strategy, article selection, or critique of sources cited.
Alternative views and emerging changes based on new studies are noted.
Quality Criteria Checklist: Review Articles
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Relevance Questions | |||
1. | Will the answer if true, have a direct bearing on the health of patients? | ??? | |
2. | Is the outcome or topic something that patients/clients/population groups would care about? | Yes | |
3. | Is the problem addressed in the review one that is relevant to dietetics practice? | Yes | |
4. | Will the information, if true, require a change in practice? | ??? | |
Validity Questions | |||
1. | Was the question for the review clearly focused and appropriate? | Yes | |
2. | Was the search strategy used to locate relevant studies comprehensive? Were the databases searched and the search termsused described? | ??? | |
3. | Were explicit methods used to select studies to include in the review? Were inclusion/exclusion criteria specified andappropriate? Wereselectionmethods unbiased? | No | |
4. | Was there an appraisal of the quality and validity of studies included in the review? Were appraisal methodsspecified,appropriate, andreproducible? | No | |
5. | Were specific treatments/interventions/exposures described? Were treatments similar enough to be combined? | No | |
6. | Was the outcome of interest clearly indicated? Were other potential harms and benefits considered? | ??? | |
7. | Were processes for data abstraction, synthesis, and analysis described? Were they applied consistently acrossstudies and groups? Was thereappropriate use of qualitative and/or quantitative synthesis? Was variation in findings among studies analyzed? Were heterogeneity issued considered? If data from studies were aggregated for meta-analysis, was the procedure described? | No | |
8. | Are the results clearly presented in narrative and/or quantitative terms? If summary statistics are used, are levels ofsignificance and/or confidence intervals included? | No | |
9. | Are conclusions supported by results with biases and limitations taken into consideration? Are limitations ofthe review identified anddiscussed? | No | |
10. | Was bias due to the review's funding or sponsorship unlikely? | Yes | |