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Hyperproteic hypocaloric enteral nutrition in the critically ill patient: A randomized controlled clinical trial

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 tr...

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Autores principales: Rugeles, Saúl-Javier, Rueda, Juan-David, Díaz, Carlos-Eduardo, Rosselli, Diego
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3902568/
https://www.ncbi.nlm.nih.gov/pubmed/24501485
http://dx.doi.org/10.4103/0972-5229.123438
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author Rugeles, Saúl-Javier
Rueda, Juan-David
Díaz, Carlos-Eduardo
Rosselli, Diego
author_facet Rugeles, Saúl-Javier
Rueda, Juan-David
Díaz, Carlos-Eduardo
Rosselli, Diego
author_sort Rugeles, Saúl-Javier
collection PubMed
description 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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spelling pubmed-39025682014-02-05 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 Indian J Crit Care Med Research Article 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. Medknow Publications & Media Pvt Ltd 2013 /pmc/articles/PMC3902568/ /pubmed/24501485 http://dx.doi.org/10.4103/0972-5229.123438 Text en Copyright: © Indian Journal of Critical Care Medicine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Rugeles, Saúl-Javier
Rueda, Juan-David
Díaz, Carlos-Eduardo
Rosselli, Diego
Hyperproteic hypocaloric enteral nutrition in the critically ill patient: A randomized controlled clinical trial
title Hyperproteic hypocaloric enteral nutrition in the critically ill patient: A randomized controlled clinical trial
title_full Hyperproteic hypocaloric enteral nutrition in the critically ill patient: A randomized controlled clinical trial
title_fullStr Hyperproteic hypocaloric enteral nutrition in the critically ill patient: A randomized controlled clinical trial
title_full_unstemmed Hyperproteic hypocaloric enteral nutrition in the critically ill patient: A randomized controlled clinical trial
title_short Hyperproteic hypocaloric enteral nutrition in the critically ill patient: A randomized controlled clinical trial
title_sort hyperproteic hypocaloric enteral nutrition in the critically ill patient: a randomized controlled clinical trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3902568/
https://www.ncbi.nlm.nih.gov/pubmed/24501485
http://dx.doi.org/10.4103/0972-5229.123438
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