Optimization of Oral Diet in Critically Ill Patients (NAP-REA)

Personalized Adapted Diet and Nutritional Follow-up With Therapeutic Education in Critically Ill Patients : Impact on Calorie and Protein Deficit, on Weight, Mortality, and Quality of Life

The purpose of the present study is to evaluate the effects of a personalized oral diet in the critically ill patients during ICU stay and after as compared usual oral diet.

This is a prospective randomized controlled single center clinical trial. This trial include patient over 18 year hospitalized in ICU and ventilated more than 5 days and/or with denutrition after 5 days of no food intake in ICU without shock and/or respiratory distress. The randomization is awebsite randomization with stratification on age, presence of sepsis at inclusion, renal failure The day of the resumption of the oral feeding (J0), realization of a protocolized swallowing test then randomization and creation of a control and intervention group Control group: Nutrition in resuscitation according to medical prescription: food recovery with a light meal consisting of soup and desserts and evolution to a normal meal according to the capabilities of patients Daily quantification of ingesta (calories and proteins) by a dietitian until the exit resuscitation. Comparison with caloric-protein targets. Nutritional evaluation before the release of resuscitation. Intervention group: NAP: "Customized Adapted Nutrition" Daily quantification of ingesta (calories and proteins) by a dietitian until the exit resuscitation. Comparison with caloric-protein targets. Therapeutic education. Nutritional evaluation before the release of resuscitation. Creation at the exit of resuscitation of a nutritional linkage sheet with instructions food The prospects for optimizing oral replenishment are multiple: reduce morbidity and mortality within 3 months after a stay in intensive care unit. improve autonomy and quality of life after a stay in intensive care. improve the privileged relationship with the patients' families. strengthen links within the resuscitation team and with downstream services. Educate patients on a nutritional level.

Optimized personalized oral nutrition in ICU and nutritional follow up with therapeutic educational after exit of ICU

Optimized personalized oral nutrition in ICU and nutritional follow up with therapeutic educational after exit of ICU

Inclusion Criteria: - patient 18 yo or above hospitalized in ICU and ventilated more than 5 days and/or with severe denutrition after 5 days of no food intake in ICU without shock and/or respiratory distress Exclusion Criteria: age under 18 yo, pregnancy, protected patients moribund patient (life expectancy of 48h or below), patient with disorders of swallowing tracheostomy patient with shock and/or respiratory distress