Critical care: Meeting protein requirements without overfeeding energy

Clinical Nutrition ESPEN
Stephen J TaylorAlex Mitchell

Abstract

Relatively high protein input has been associated with improved clinical outcome in critical illness. However, until recently differences in clinical outcome have been examined in terms of the energy goal-versus under-feeding. Most studies failed to set the energy goal by an accurate measure or estimate of expenditure or independently set protein prescription. This leads to under-prescription of protein, possibly adversely affecting outcome. We determined whether an enteral nutrition prescription could meet local and international protein guidelines. Protein prescriptions of consecutive patients admitted to Southmead Hospital ICU and requiring full enteral nutrition were audited against local and international guidelines. Prescriptions were designed to not exceed energy expenditure based on a validated estimation equation, minus non-nutritional energy, and protein requirements were based on local or international guidelines of between 1.2 and 2.5 g protein/kg/d or 2-2.5/kg ideal body weight (Hamwi ideal body weight)/d. From 15/1/15 to 12/4/15 139 ICU patients were prescribed full enteral nutrition. Protein prescriptions failed to meet local guidelines in 75% (p < 0.001) and international guidelines in 45-100%. Prescriptions mee...Continue Reading

References

Jun 10, 2009·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Pierre Singer ESPEN
Jul 1, 2011·The New England Journal of Medicine·Michael P CasaerGreet Van den Berghe
Oct 19, 2012·World Review of Nutrition and Dietetics·Gianni Biolo
May 21, 2013·Lancet·Claudia Paula HeideggerClaude Pichard
May 21, 2015·The New England Journal of Medicine·Yaseen M ArabiUNKNOWN PermiT Trial Group

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Citations

Apr 28, 2018·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·L John Hoffer
Nov 20, 2018·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Alexandra MitchellStephen Taylor
Feb 23, 2020·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Michele ApSimonBethany Hopkins
Jun 27, 2019·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Bethany HopkinsCathy Alberda

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