Practices, barriers, and opportunities for dietitians-nutrionists in critical care in Latin America: A cross-sectional study.

BACKGROUND

Dietitians-nutritionists (DNs) play a key role in intensive care units (ICUs), yet their scope of practice varies across settings. This study aimed to describe the professional practices of DNs working in ICUs in Latin America and to identify factors associated with their level of professional activity.

METHODS

A cross-sectional study was conducted using an online survey targeting DNs working in ICUs across 18 Latin American countries. The survey included two questionnaires: one assessing professional functions and responsibilities, and another evaluating practices, dynamics, and resources for nutritional care.

RESULTS

A total of 223 responses were obtained, mainly from Argentina, Chile, Colombia, Peru, and Mexico. Respondents reported a median of 10 years of professional experience (interquartile range: 6-16). Most worked in high-complexity public hospitals (141 [63.2%]) and reported ≥40 h workweeks (144 [64.6%]); 137 (61.4%) held postgraduate degrees. Systematic participation in nutritional assessment, intervention, and monitoring was reported by 165 (74.0%), 183 (82.1%), and 168 (75.3%) respondents, respectively. Only 97 (43.5%) were authorized to prescribe nutritional therapy, with institutional policies identified as the main barrier. Academic involvement was limited, with 91 (41.7%) occasionally participating in teaching and 93 (42.1%) in research. The NRS-2002 was the most commonly used screening tool; only 16 (7.2%) reported access to indirect calorimetry, and 120 (53.8%) assessed muscle mass, mainly by anthropometry

CONCLUSIONS

DNs in Latin America play an active role in ICU nutritional care but face important limitations in clinical autonomy, access to diagnostic tools, and academic participation.