Impact of the reduction of the recommended energy target in the ICU on protein delivery and clinical outcomes

Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition
M M BergerM D Schaller

Abstract

Energy targets are a matter of debate for intensive care (ICU) patients. As the guidelines have evolved, energy targets have been reduced, while the protein intake objectives have increased. The impact of these changes remains largely unknown. This quality study aimed at investigating the clinical impact of these changes in patients with an ICU stay >3 days. Observational cohort study over two 3 months periods (A, B), with distinct prevailing nutrition recommendations in patients admitted consecutively to a multidisciplinary ICU. Inclusion criterion: ICU stay >3 days. Recorded variables: severity scores, energy target and delivery, protein delivery, feeding route, length of stay (ICU, hospital) and hospital outcome. Data as mean, SD and IQR. The analysis included 389 patients, and 3920 observation days. Except for patient age (A versus B: 57.8 and 62.3 years; p = 0.010) and NRS (4.3 vs 3.9 respectively p = 0.002), the cohorts were similar. Compared to A, the mean prescribed energy target decreased by 125 kcal (1947 kcal/d vs. 1822 kcal*day-1respectively), resulting in lower energy delivery (1353 kcal*day-1vs. 1238 kcal*day-1; p < 0.0001), and reduced protein delivery (81 g*day-1vs. 65 g*day-1: p < 0.0001). These differences wer...Continue Reading

Citations

Apr 28, 2018·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·L John Hoffer
Sep 20, 2018·JPEN. Journal of Parenteral and Enteral Nutrition·Susan RobertsLaura Byham-Gray
Feb 12, 2019·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Bianca D ArneyStacy Pelekhaty
Feb 12, 2019·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Karen Allen, Leah Hoffman
May 27, 2017·Current Opinion in Critical Care·Peter J M Weijs
Jun 9, 2020·Hospital Pharmacy·Christopher T Buckley, Roland N Dickerson

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