ORIGINAL ARTICLEComputerized energy balance and complications in critically ill patients: An observational study
Section snippets
Study population
The study was conducted in the General Intensive Care Department of Rabin Medical Center, a university-affiliated tertiary hospital, between October 2002 and May 2003. During this period, 248 patients were treated in the 10 beds ICU. Only those requiring at least 96 h of mechanical ventilation were included in the study. Patients who received a fraction of inspired oxygen of >60% at the time of indirect calorimetry or who had air leaks around the respiratory circuit were excluded, as were
Results
Fifty patients (33 men, seven women) were found eligible for the study. Their background data are shown in Table 1. Mean caloric intake was 1512 kcal per 24 h (range 400–3210 kcal/day). Mean energy balance was −460 kcal per 24 h (range −1025 to +259 kcal/day), and mean cumulative energy balance,−4767 kcal. The cumulative energy balance was below −10,000 kcal in 11 patients, between −4000 and −10,000 kcal in 15 patients, and above −4000 kcal in 24. Mean IV dextrose intake was 163 kcal/day, or 12% of the
Discussion
This observational study shows that a negative energy balance is highly correlated to the occurrence of complications in the ICU. The use of a computerized bedside information system together with indirect calorimetry measurements increased the ability to assess energy balance on a daily basis. The literature contains an extensive body of data on the value of indirect calorimetry in assessing the caloric requirements of critically ill patients.17, 18, 19 However, only few studies in adults have
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Cited by (334)
ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit
2023, Clinical NutritionImpact of oral or enteral nutritional support on clinical outcomes of patients subjected to cardiac surgery: A systematic review
2022, Clinical Nutrition ESPENCitation Excerpt :Due to the lack of data related to the cardiac population, studies conducted with critical and surgical patients are usually highlighted in the literature. Those studies show a higher number of complications, poor wound healing, longer mechanical ventilation time, reduced muscle mass, increased readmission, and mortality rates, in situations where nutritional support is inadequate [12,17–22]. Despite the likely impacts of cardiac surgery on nutritional condition and the possible benefits of perioperative nutritional support, to date, there are no specific guidelines standardizing nutritional therapy in these patients.
How much underfeeding can the critically ill adult patient tolerate?
2022, Journal of Intensive Medicine