How we’ve used the NUTRIC Score is on day 3, we do the risk assessment to see if they’re high risk versus low risk, and it’s the high risk patients who we need to optimally feed. My assumption is, you’re talking about a mechanically ventilated ICU patient in whom you have already started some form of early enteral nutrition within 24 or 48 hours, and I don’t think you need any tool to tell you if a critically ill patient on mechanical ventilation needs to be tube-fed. I have observed people using it as a decision tree to figure out when to start enteral nutrition versus not, the idea being that a low risk patient doesn’t need to be fed whatsoever, and that is not how we conceptualized or validated the tool.
What pearls, pitfalls and/or tips do you have for users of the NUTRIC Score? Do you know of cases when it has been applied, interpreted, or used inappropriately? So there was a need for a tool for critically ill patients that helped discriminate who’s nutritionally high risk and therefore would benefit more from optimal nutrition. We talked a lot about nutrition risk assessments and malnutrition screening, and most of the tools that are out there were developed and validated for non-ICU patients or said differently, people in hospitalized settings or outpatient settings. It was more the recognition that clinicians were not able to discriminate patients who would benefit the most from being aggressive with nutrition therapy versus those where it didn’t seem to really matter. Why did you develop the NUTRIC Score? Was there a particular clinical experience or patient encounter you had that inspired you to start this research?
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