کد مقاله کد نشریه سال انتشار مقاله انگلیسی ترجمه فارسی نسخه تمام متن
3276101 1208528 2016 4 صفحه PDF سفارش دهید دانلود کنید
عنوان انگلیسی مقاله
The dilemma of protein delivery in the intensive care unit
ترجمه فارسی عنوان
معضل ارائه پروتئین در بخش مراقبت های ویژه
کلمات کلیدی
مراقبتهای ویژه؛ واحد مراقبت های ویژه؛ تغذیه درمانی؛ ارائه پروتئین؛ ارائه انرژی؛ منابع انرژی غیرتغذیه
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی غدد درون ریز، دیابت و متابولیسم
چکیده انگلیسی


• Early enteral nutrition (EN) with currently available EN formula provides insufficient protein.
• Non-nutritional energy sources add to nonprotein energy delivery.
• Novel EN formulae with a lower nonprotein energy-to-nitrogen ratio are needed.

ObjectiveOptimal protein delivery in the intensive care unit (ICU) may offer a significant mortality benefit, whereas energy overfeeding leads to worse outcomes. The aim of the present study was to assess actual protein versus energy delivery in a multidisciplinary adult ICU.MethodsWe conducted a retrospective review of ICU charts to determine total protein delivery and energy delivery, inclusive of non-nutritional energy sources (NNES), from admission until a maximum of 7 d. The outcome variables were protein and energy delivery relative to targets and cumulative protein and energy balance.ResultsWe included 71 patients (49% male), with a mean age of 49.2 ± 17.1 y. Of the patients, 68% were medical and 32% surgical. Nutrition therapy was initiated within 14.5 ± 14.1 h. The majority (80%) received enteral nutrition (EN). Median protein delivery and energy delivery were 75 g/d (1.1 g·kg·d−1, range 21–135 g/d) and 1642 kcal/d (26 kcal·kg·d−1, range 740–2619 kcal/d), meeting 89% (range 24–103%) and 100% (range 39–133%) of target, respectively. NNES, mostly from carbohydrate-containing intravenous fluids, contributed 8% (range 0–29%) to total energy delivery (133 kcal/d, range 0–561). Protein and energy underfeeding occurred in 51% and 27% of cases, respectively. Only 59% of those with an adequate energy delivery (90–110% of target) achieved an adequate protein delivery. A significant negative correlation was found between cumulative protein and energy balance and time to initiation of NT (protein: R = −0.33, P = 0.006; energy: R = −0.28, P = 0.017).ConclusionsEarly initiation of EN with currently available energy-rich formulas is insufficient to achieve adequate protein delivery. NNES add to total energy delivery. Novel EN formulas with a lower nonprotein energy-to-nitrogen ratio may help to optimize protein delivery without the harmful effects of energy overfeeding.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Nutrition - Volume 32, Issue 9, September 2016, Pages 985–988
نویسندگان
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