Achieving protein targets without energy overfeeding in critically ill patients: A prospective feasibility study
| Autor: | Nadine Denneman, B. Broens, H. M. Oudemans-van Straaten, Wilhelmus G. P. M. Looijaard, Peter J.M. Weijs, Armand R. J. Girbes |
|---|---|
| Přispěvatelé: | Intensive care medicine, Internal medicine, ACS - Diabetes & metabolism, AII - Inflammatory diseases, AGEM - Endocrinology, metabolism and nutrition, APH - Aging & Later Life, Neurosurgery, Graduate School, Lectoraat Voeding en Beweging, Kenniscentrum Bewegen, Sport en Voeding |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Critical Care Critical Illness Nutritional Status 030209 endocrinology & metabolism Critical Care and Intensive Care Medicine Enteral administration Gastroenterology law.invention 03 medical and health sciences Overnutrition 0302 clinical medicine law Internal medicine Clinical endpoint Humans Medicine Prospective Studies Amino Acids Aged 030109 nutrition & dietetics Nutrition and Dietetics business.industry Critically ill High protein Acute kidney injury Middle Aged medicine.disease Intensive care unit Parenteral nutrition Critical illness Feasibility Studies Female Dietary Proteins Energy Intake business |
| Zdroj: | Clinical Nutrition, 38(6), 2623-2631. Churchill Livingstone Clinical nutrition (Edinburgh, Scotland). Churchill Livingstone Looijaard, W G P M, Denneman, N, Broens, B, Girbes, A R J, Weijs, P J M & Oudemans-van Straaten, H M 2019, ' Achieving protein targets without energy overfeeding in critically ill patients: A prospective feasibility study ', Clinical Nutrition, vol. 38, no. 6, pp. 2623-2631 . https://doi.org/10.1016/j.clnu.2018.11.012 Clinical Nutrition, 38(6), 2623-2631. Elsevier Ltd. |
| ISSN: | 1532-1983 0261-5614 |
| DOI: | 10.1016/j.clnu.2018.11.012 |
| Popis: | Background & aims: High protein delivery during early critical illness is associated with lower mortality, while energy overfeeding is associated with higher mortality. Protein-to-energy ratios of traditional enteral formulae are sometimes too low to reach protein targets without energy overfeeding. This prospective feasibility study aimed to evaluate the ability of a new enteral formula with a high protein-to-energy ratio to achieve the desired protein target while avoiding energy overfeeding. Methods: Mechanically ventilated non-septic patients received the high protein-to-energy ratio nutrition during the first 4 days of ICU stay (n = 20). Nutritional prescription was 90% of measured energy expenditure. Primary endpoint was the percentage of patients reaching a protein target of ≥1.2 g/kg ideal body weight on day 4. Other endpoints included a comparison of nutritional intake to matched historic controls and the response of plasma amino acid concentrations. Safety endpoints were gastro-intestinal tolerance and plasma urea concentrations. Results: Nineteen (95%) patients reached the protein intake target of ≥1.2 g/kg ideal body weight on day 4, compared to 65% in historic controls (p = 0.024). Mean plasma concentrations of all essential amino acids increased significantly from baseline to day 4. Predefined gastro-intestinal tolerance was good, but unexplained foul smelling diarrhoea occurred in two patients. In one patient plasma urea increased unrelated to acute kidney injury. Conclusions: In selected non-septic patients tolerating enteral nutrition, recommended protein targets can be achieved without energy overfeeding using a new high protein-to-energy ratio enteral nutrition. Keywords: Amino acids; Caloric overfeeding; Critical illness; Gastro-intestinal tolerance; High protein; Intensive care unit. |
| Databáze: | OpenAIRE |
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