Propofol sedation substantially increases the caloric and lipid intake in critically ill patients
| Autor: | Jennifer Hastings, Oliver Bianchet, Carlos Scheinkestel, M. Charrière, Emma J. Ridley, Mette M. Berger |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Critical Care Endocrinology Diabetes and Metabolism Sedation Critical Illness Enteral administration Propofol sedation law.invention 03 medical and health sciences 0302 clinical medicine Enteral Nutrition law medicine Humans Hypnotics and Sedatives Propofol Retrospective Studies 030109 nutrition & dietetics Nutrition and Dietetics Critically ill business.industry Caloric theory 030208 emergency & critical care medicine Length of Stay Middle Aged Intensive care unit Lipids Intensive Care Units SAPS II Anesthesia medicine.symptom business Energy Intake medicine.drug |
| Zdroj: | Nutrition (Burbank, Los Angeles County, Calif.). 42 |
| ISSN: | 1873-1244 |
| Popis: | Objective The amount of lipid delivered to patients varies considerably depending on the non-nutritional intake from sedation, and on the feeding solution. The aim of this study was to quantify the magnitude and proportion of lipids and energy provided from propofol sedation in intensive care unit (ICU) patients. Methods This was a retrospective analysis of prospectively collected data in consecutive patients admitted to the ICUs of two university hospitals. Inclusion criterion included an ICU stay >5 d. Data were collected for a maximum of 10 d. Propofol sedation using 1% or 2% propofol solutions was defined as >100 mg/d. Nutritional management was per protocol in both centers, recommending enteral feeding. Data are shown as means ± standard deviation. Results In all, 701 admissions (687 patients, ages 59 ± 16 y, SAPS II 51 ± 17) and 6485 d, including 3484 propofol sedation days were analyzed. Energy targets were 1987 ± 411 kcal/d; mean energy delivery was 1362 ± 811 kcal/d (70% ± 38% of prescription) including propofol and dextrose. Enteral feeding dominated (75% of days) and progressed similarly in both ICUs. Mean propofol sedation dose was 2045 ± 1650 mg/d, resulting in 146 ± 117 kcal/d. Fat from propofol constituted 17% of total energy (up to 100% during the first days). Fat delivery (40 ± 23 g/d: maximum 310 g/d) was significantly increased by the combination of propofol sedation, the 1% solution, and high-fat–containing feeds. In survivors, high-fat proportion was associated with prolonged ventilation time ( P Conclusion Propofol sedation resulted in large doses of lipids being delivered to patients, some receiving pure lipids during the first days. As the metabolic effects of high proportions of fat are unknown, further research is warranted. |
| Databáze: | OpenAIRE |
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