ESPEN 2013 - Late breaking abstract submission

Late Breaking Abstract

ESPEN13-1829

ENERGY TARGETED NUTRITION STRATEGY DOES NOT PROVIDE ADEQUATE PROTEIN IN CRITICALLY ILL PATIENTS

I. Cankayali¹O. Ergenoglu¹C. Bor¹K. Demirag¹M. Uyar^1,*

¹Anesthesiology and Intensive Care, Ege University Hospital, Izmir, Türkiye

Rationale: It is important to monitor the energy and protein requirements and the actually given amount during the initiation and maintenance of nutrition support in critically ill patients. In general practice, nutritional support is usually energy targeted. Despite adequate energy supply, this strategy might cause protein deficiency.

In this retrospective study, we aimed to compare the targeted and actual energy/protein supply and to evaluate nitrogen balance in ICU patients with enteral, parenteral or combined nutritional support.

Methods: 217 ICU patients with a mean APACHE II score of 19.5 and having a complete nitrogen balance calculation records were included. The patients were divided into three groups as enteral, parenteral and combined nutritional support.

Results: Table 1. Energy and protein balance (median values)

	All patients (n=217)	Enteral (n= 149)	Parenteral (n= 46)	Combined (n= 22)
Target / actual energy (kcal/d)	1650 / 1688	1660 / 1680	1535 / 1616	1751,50 / 1896^*
Target / actual protein (g/d)	97,4 / 80,6*	98,3 / 86,4^*	97,42 / 63,8^*	93,4 / 89,8
Nitrogen balance (g/d)	-2,59	-2,4	− 5,33 ^{† / † †}	0,03
Volume (ml/d)	1680	1560	1680^{† †}	2038^{† / † † †}

*p < 0.05 Target vs actual values, † p< 0,05 Parenteral vs combined, †† p< 0,05 Parenteral vs enteral, ††† p< 0,05 Enteral vs combined

Conclusion: Energy targeted nutrition support may cause inadequate protein delivery and increased nitrogen deficiency especially in parenterally fed patients. The same strategy resulted in over provision of calories and volume in combined nutrition group.

References:

Disclosure of Interest: None Declared

Keywords: energy balance, nitrogen balance