Clinical Nutritional Practices among Critically Ill Patients in Intensive Care Units: A Cross-Sectional Study at a Tertiary Care Hospital, Nepal

Background: Proper nutrition is essential for managing critically ill patients in intensive care units (ICUs) and significantly influences their recovery and outcomes. Understanding patient demographics, dietary habits, and effective nutritional strategies is crucial for optimizing care quality in ICU settings.  Objectives: This study aimed to investigate the clinical nutritional practices among critically ill patients in ICUs at Manmohan Memorial Medical College and Teaching Hospital in Kathmandu, Nepal. Specifically, it sought to analyze demographic profiles, dietary habits, types of nutritional support utilized (oral, tube feeding, intravenous), and their associations with health conditions such as Hypertension (HTN), chronic kidney disease (CKD), Chronic Obstructive Pulmonary Disease (COPD), and Diabetes Mellitus (DM).  Methodology: A retrospective and descriptive cross-sectional research design was employed, involving 89 ICU patients selected through purposive sampling. Data were collected from the ICU Diet Prescription Form and Registry 2023. Statistical analyses included descriptive statistics and chi-square tests to assess associations between nutritional variables and health conditions across patient groups.  Result: The study found that most ICU patients were aged 55-74 years (39.3%), with equal gender distribution (50.6% male). Non-vegetarian diets were prevalent (83.1%), and specialized diets (e.g., renal, high-protein) were prescribed based on medical needs. Meal frequency averaged every 3 hours (50.6%), highlighting tailored nutritional care practices. Oral feeding was the predominant nutritional support method (42.7%), followed by tube feeding (32%) and intravenous feeding (19.1%). Significant associations were observed between specific nutritional variables like special diet provided, amount of fluid balance and length of hospital stay, and health conditions (HTN, CKD, COPD, DM), emphasizing the importance of personalized nutrition based on health conditions. COPD patients exhibited longer ICU and hospital stays compared to other conditions.  Conclusion: This study underscores the critical role of personalized nutrition plans tailored to individual patient needs in ICU settings. Implementation of evidence-based nutritional guidelines and multidisciplinary approaches is crucial to enhance patient care and improve clinical outcomes. Future research should focus on refining nutritional protocols and exploring innovative nutritional therapies to further optimize ICU patient management in Nepal and beyond.