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Free Fatty Acids’ Level and Nutrition in Critically Ill Patients and Association with Outcomes: A Prospective Sub-Study of PermiT Trial

Objectives: The objectives of this study were to evaluate the clinical and nutritional correlates of high free fatty acids (FFAs) level in critically ill patients and the association with outcomes, and to study the effect of short-term caloric restriction (permissive underfeeding) on FFAs level duri...

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Autores principales: Arabi, Yaseen M., Tamimi, Waleed, Jones, Gwynne, Jawdat, Dunia, Tamim, Hani, Al-Dorzi, Hasan M., Sadat, Musharaf, Afesh, Lara, Sakhija, Maram, Al-Dawood, Abdulaziz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6412238/
https://www.ncbi.nlm.nih.gov/pubmed/30781774
http://dx.doi.org/10.3390/nu11020384
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author Arabi, Yaseen M.
Tamimi, Waleed
Jones, Gwynne
Jawdat, Dunia
Tamim, Hani
Al-Dorzi, Hasan M.
Sadat, Musharaf
Afesh, Lara
Sakhija, Maram
Al-Dawood, Abdulaziz
author_facet Arabi, Yaseen M.
Tamimi, Waleed
Jones, Gwynne
Jawdat, Dunia
Tamim, Hani
Al-Dorzi, Hasan M.
Sadat, Musharaf
Afesh, Lara
Sakhija, Maram
Al-Dawood, Abdulaziz
author_sort Arabi, Yaseen M.
collection PubMed
description Objectives: The objectives of this study were to evaluate the clinical and nutritional correlates of high free fatty acids (FFAs) level in critically ill patients and the association with outcomes, and to study the effect of short-term caloric restriction (permissive underfeeding) on FFAs level during critical illness. Patients/Method: In this pre-planned sub-study of the PermiT (Permissive Underfeeding vs. Target Enteral Feeding in Adult Critically Ill Patients) trial, we included critically ill patients who were expected to stay for ≥14 days in the intensive care unit. We measured FFAs level on day 1, 3, 5, 7, and 14 of enrollment. Of 70 enrolled patients, 23 (32.8%) patients had high FFAs level (baseline FFAs level >0.45 mmol/L in females and >0.6 mmol/L in males). Results: Patients with high FFAs level were significantly older and more likely to be females and diabetics and they had lower ratio of partial pressure of oxygen to the fraction of inspired oxygen, higher creatinine, and higher total cholesterol levels than those with normal FFAs level. During the study period, patients with high FFAs level had higher blood glucose and required more insulin. On multivariable logistic regression analysis, the predictors of high baseline FFAs level were diabetes (adjusted odds ratio (aOR): 5.36; 95% confidence interval (CI): 1.56, 18.43, p = 0.008) and baseline cholesterol level (aOR, 4.29; 95% CI: 11.64, 11.19, p = 0.003). Serial levels of FFAs did not differ with time between permissive underfeeding and standard feeding groups. FFAs level was not associated with 90-day mortality (aOR: 0.49; 95% CI: 0.09, 2.60, p = 0.40). Conclusion: We conclude that high FFAs level in critically ill patients is associated with features of metabolic syndrome and is not affected by short-term permissive underfeeding.
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spelling pubmed-64122382019-03-29 Free Fatty Acids’ Level and Nutrition in Critically Ill Patients and Association with Outcomes: A Prospective Sub-Study of PermiT Trial Arabi, Yaseen M. Tamimi, Waleed Jones, Gwynne Jawdat, Dunia Tamim, Hani Al-Dorzi, Hasan M. Sadat, Musharaf Afesh, Lara Sakhija, Maram Al-Dawood, Abdulaziz Nutrients Article Objectives: The objectives of this study were to evaluate the clinical and nutritional correlates of high free fatty acids (FFAs) level in critically ill patients and the association with outcomes, and to study the effect of short-term caloric restriction (permissive underfeeding) on FFAs level during critical illness. Patients/Method: In this pre-planned sub-study of the PermiT (Permissive Underfeeding vs. Target Enteral Feeding in Adult Critically Ill Patients) trial, we included critically ill patients who were expected to stay for ≥14 days in the intensive care unit. We measured FFAs level on day 1, 3, 5, 7, and 14 of enrollment. Of 70 enrolled patients, 23 (32.8%) patients had high FFAs level (baseline FFAs level >0.45 mmol/L in females and >0.6 mmol/L in males). Results: Patients with high FFAs level were significantly older and more likely to be females and diabetics and they had lower ratio of partial pressure of oxygen to the fraction of inspired oxygen, higher creatinine, and higher total cholesterol levels than those with normal FFAs level. During the study period, patients with high FFAs level had higher blood glucose and required more insulin. On multivariable logistic regression analysis, the predictors of high baseline FFAs level were diabetes (adjusted odds ratio (aOR): 5.36; 95% confidence interval (CI): 1.56, 18.43, p = 0.008) and baseline cholesterol level (aOR, 4.29; 95% CI: 11.64, 11.19, p = 0.003). Serial levels of FFAs did not differ with time between permissive underfeeding and standard feeding groups. FFAs level was not associated with 90-day mortality (aOR: 0.49; 95% CI: 0.09, 2.60, p = 0.40). Conclusion: We conclude that high FFAs level in critically ill patients is associated with features of metabolic syndrome and is not affected by short-term permissive underfeeding. MDPI 2019-02-13 /pmc/articles/PMC6412238/ /pubmed/30781774 http://dx.doi.org/10.3390/nu11020384 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Arabi, Yaseen M.
Tamimi, Waleed
Jones, Gwynne
Jawdat, Dunia
Tamim, Hani
Al-Dorzi, Hasan M.
Sadat, Musharaf
Afesh, Lara
Sakhija, Maram
Al-Dawood, Abdulaziz
Free Fatty Acids’ Level and Nutrition in Critically Ill Patients and Association with Outcomes: A Prospective Sub-Study of PermiT Trial
title Free Fatty Acids’ Level and Nutrition in Critically Ill Patients and Association with Outcomes: A Prospective Sub-Study of PermiT Trial
title_full Free Fatty Acids’ Level and Nutrition in Critically Ill Patients and Association with Outcomes: A Prospective Sub-Study of PermiT Trial
title_fullStr Free Fatty Acids’ Level and Nutrition in Critically Ill Patients and Association with Outcomes: A Prospective Sub-Study of PermiT Trial
title_full_unstemmed Free Fatty Acids’ Level and Nutrition in Critically Ill Patients and Association with Outcomes: A Prospective Sub-Study of PermiT Trial
title_short Free Fatty Acids’ Level and Nutrition in Critically Ill Patients and Association with Outcomes: A Prospective Sub-Study of PermiT Trial
title_sort free fatty acids’ level and nutrition in critically ill patients and association with outcomes: a prospective sub-study of permit trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6412238/
https://www.ncbi.nlm.nih.gov/pubmed/30781774
http://dx.doi.org/10.3390/nu11020384
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