Observational study to assess the relationship between enteral nutrition delivery and nutritional biomarkers among mechanically ventilated critically ill patients

BACKGROUND: Biochemical assessment is considered a useful tool in assessing the patient’s nutritional status and intake. However, during critical illness, nutritional biomarkers, such as albumin, and haemoglobin (HB) may reflect the severity of acute illness. The aim of this study is to assess the relationship between energy and protein delivery with the change in albumin, HB, “mean corpuscular volume”(MCV), and “mean corpuscular haemoglobin concentration” (MCHC) levels in critically ill patients. METHOD: In this prospective observational study we monitored the intake of energy and protein in a group critically ill patients for 6 consecutive days. Biochemical data including albumin, HB, MCV and MCHC was measured on admission and on day 6 of the follow-up. The variation in the biomarkers between admission and day 6 was calculated as the follow-up reading minus the reading obtained upon admission to (Intensive Care Unit) ICU. RESULTS: This study included 43 patients. There was a significant difference in the albumin and HB levels between admission and follow up readings. No statistical association was recorded between the intake and the changes in albumin, MCV and MCHC level during ICU stay. The results showed a significant association between the intake of energy (R = 0.393), and protein (R = 0.385), with the increase in HB level during hospitalisation. CONCLUSION: Overall, this study showed that most nutritional biomarkers were not influenced by nutritional therapy during the acute phase of illness. These findings may directly undermine the usefulness of the serial measurements of these biomarkers in the early phase of ICU admission.