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Hyperproteic hypocaloric enteral nutrition in the critically ill patient: A randomized controlled clinical trial.
Rugeles, Saúl-Javier; Rueda, Juan-David; Díaz, Carlos-Eduardo; Rosselli, Diego.
Afiliação
  • Rugeles SJ; Department of Surgery, Pontificia Universidad Javeriana, Medical School, Bogotá, Colombia.
  • Rueda JD; Department of Surgery, Pontificia Universidad Javeriana, Medical School, Bogotá, Colombia ; Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Medical School, Bogotá, Colombia.
  • Díaz CE; Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Medical School, Bogotá, Colombia.
  • Rosselli D; Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Medical School, Bogotá, Colombia.
Indian J Crit Care Med ; 17(6): 343-9, 2013 Nov.
Article em En | MEDLINE | ID: mdl-24501485
INTRODUCTION: Our aim was to evaluate the impact of hyperproteic hypocaloric enteral feeding on clinical outcomes in critically ill patients, particularly on severity of organic failure measured with the Sequential Organ Failure Assessment (SOFA). MATERIALS AND METHODS: In a double blind clinical trial, 80 critically ill adult patients were randomized to hyperproteic hypocaloric or to isocaloric enteral nutrition; all patients completed follow-up of at least 4 days. Prescribed caloric intake was: Hyperproteic hypocaloric enteral nutrition (15 kcal/kg with 1.7 g/kg of protein) or isocaloric enteral nutrition (25 kcal/kg with 20% of the calories as protein). The main outcome was the differences in delta SOFA at 48 h. Secondary outcomes were intensive care unit (ICU) length of stay, days on ventilator, hyperglycemic events, and insulin requirements. RESULTS: There were no differences in SOFA score at baseline (7.5 (standard deviation (SD) 2.9) vs 6.7 (SD 2.5) P = 0.17). The total amount of calories delivered was similarly low in both groups (12 kcal/kg in intervention group vs 14 kcal/kg in controls), but proteic delivery was significantly different (1.4 vs 0.76 g/kg, respectively P ≤ 0.0001). The intervention group showed an improvement in SOFA score at 48 h (delta SOFA 1.7 (SD 1.9) vs 0.7 (SD 2.8) P = 0.04) and less hyperglycemic episodes per day (1.0 (SD 1.3) vs 1.7 (SD 2.5) P = 0.017). DISCUSSION: Enteral hyperproteic hypocaloric nutrition therapy could be associated with a decrease in multiple organ failure measured with SOFA score. We also found decreased hyperglycemia and a trend towards less mechanical ventilation days and ICU length of stay.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Clinical_trials Idioma: En Revista: Indian J Crit Care Med Ano de publicação: 2013 Tipo de documento: Article País de afiliação: Colômbia País de publicação: Índia
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Clinical_trials Idioma: En Revista: Indian J Crit Care Med Ano de publicação: 2013 Tipo de documento: Article País de afiliação: Colômbia País de publicação: Índia