A prospective study of energy and protein intakes in critically ill patients

Hasanloei, Mohammad Amin Valizade; Vahabzadeh, Davoud; Shargh, Ali; Atmani, A.; Osalou, R. Alizadeh

doi:10.1016/j.clnesp.2017.10.007

Cited by 8 publications

(6 citation statements)

References 28 publications

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“…Large body of literature has found that dysglycemia including hyperglycemia, hypoglycemia and the increased glucose variability is independently associated with mortality in critically ill patients 15,16 .Furthermore, there were evidences showing that the blood glucose level on admission is also independently associated with adverse outcomes in patients with community acquired pneumonia (CAP). Earlier, admission glucose level >14 mmol/l was identified as one of the 20 factors associated with poor outcomes in CAP 6 .…”

Section: Discussionmentioning

confidence: 99%

Effects of Diabetes and Blood Glucose on COVID-19 Mortality: A Retrospective Observational Study

Cai

Gao

et al. 2021

Preprint

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OBJECTIVETo investigate the association of diabetes and blood glucose on mortality of patients with Coronavirus Disease 2019 (COVID-19).RESEARCH DESIGN AND METHODSThis was a retrospective observational study of all patients with COVID-19 admitted to Huo-Shen-Shan Hospital, Wuhan, China. The hospital was built only for treating COVID-19 and opened on February 5, 2020. The primary endpoint was all-cause mortality during hospitalization.RESULTSAmong 2877 hospitalized patients, 13.5% (387/2877) had a history of diabetes and 1.9% (56/2877) died in hospital. After adjustment for confounders, patients with diabetes had a 2-fold increase in the hazard of mortality as compared to patients without diabetes (adjusted HR 2.11, 95%CI: 1.16-3.83, P=0.014). The on-admission glucose (per mmol/L≥4mmol/L) was significantly associated with subsequent mortality on COVID-19 (adjusted HR 1.17, 95%CI: 1.10-1.24, P<0.001).CONCLUSIONSDiabetes and on-admission glucose (per mmol/L≥4mmol/L) are associated with increased mortality in patients with COVID-19. These data support that blood glucose should be properly controlled for possibly better survival outcome in patients with COVID-19.

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Section: Discussionmentioning

confidence: 99%

Effects of Diabetes and Blood Glucose on COVID-19 Mortality: A Retrospective Observational Study

Cai

Gao

et al. 2021

Preprint

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“…1 It has been shown that despite efforts for adequate energy and protein prescription, many patients continue to receive suboptimal energy intake, which is associated with poorer outcomes. [2][3][4][5] Critically ill patients in the intensive care unit (ICU) are susceptible to feeding interruptions, some of them avoidable, that can decrease their total energy intake and affect their hospitalization by prolonging their ICU and hospital length of stay (LOS). 6 Oftentimes, however, the reason for suboptimal energy intake is unintentional and relates to lack of adequate resources or standardized practices across institutions that pertain to energy prescription and nutrition monitoring.…”

Section: Introductionmentioning

confidence: 99%

Use of Predictive Equations for Energy Prescription Results in Inaccurate Estimation in Trauma Patients

et al. 2019

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Background Overfeeding and underfeeding are associated with poor clinical outcomes. In the absence of indirect calorimetry (IC), the Society of Critical Care Medicine/ASPEN recommend prescribing 25–30 kcal/kg. The Harris‐Benedict equation (HBE) multiplied by a stress factor is commonly applied in critically ill patients. We describe the difference between estimated and actual energy needs in critically injured patients. Methods From March to November 2018, we collected demographics and energy needs determined by continuous IC (started within 4 days) in intubated adults. Ideal or adjusted body weight was used for 25–30 kcal/kg, and HBE was multiplied by a 1.3 stress factor (1.3HBE). Daily requirements up to 14 days, extubation, or death were calculated using all 3 methods and compared with IC. Results Fifty‐five subjects were included. Median age was 38 [27–58] years, 38 (69%) were male, body mass index was 28 [25–33] kg/m2, and Acute Physiology and Chronic Health Evaluation II score was 17 [14–24] Mechanism of injury was blunt (38, 69%), penetrating (9, 16%), and burn (8, 15%). By day 14, compared with measured energy requirements by IC, the other methods could result in a cumulative 1827‐kcal (+7%) surplus (1.3HBE), a 1313‐kcal (−5%) deficit (25 kcal/kg), or a 3950‐kcal (+14%) surplus (30 kcal/kg) per patient over a median 9 days. Conclusion In critically injured patients, predictive equations for energy needs do not account for dynamic metabolic changes over time and could result in underfeeding or overfeeding. Adjusting daily prescription based on continuous IC may result in better individualized treatment.

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“…In the case of critically ill in-patients, considering that this is the evidence base that we have available for decision-making with regard to Covid-19 critical patients, in general, the clinical evolution with high mortality rates can occur, especially if we consider malnourished patients and those with increased infections, complications, hypermetabolism and longer hospital stay, who can often have low energy and protein intake when fed by nutritional therapy [36][37][38][39][40][41][42][43]. When they are undergoing nutritional therapy, it is observed that these critical patients are unable to reach the goals that were defined for energy and proteins, and there is an influence of the energy and protein deficit on the length of hospital stay and mortality [40,44,45].…”

Section: N U T R I T I O N a L T H E R A P Y I N C R I T I C A L P A mentioning

confidence: 99%

Nutritional therapy in hospital care of in-patients with Covid-19: evidence, consensus and practice guidelines

et al. 2020

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Objective The objective of this work was to review papers that deal with nutritional therapy of inpatients with Covid-19 from the beginning of the pandemic. The survey covered the period until the month of September 2020. Methods This is a review of the indexed literature (Scopus, Pubmed and Lilacs), including area consensus. Results The review showed that the initial recommendations were based on generic assumptions and, as specific knowledge was being produced, the recommendations became more targeted. Conclusion In the health crisis generated by Covid-19, in the context of uncertainties related to nutritional care procedures, knowledge and action strategies were generated, coordinated by researchers and health professionals.

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A prospective study of energy and protein intakes in critically ill patients

Cited by 8 publications

References 28 publications

Effects of Diabetes and Blood Glucose on COVID-19 Mortality: A Retrospective Observational Study

Effects of Diabetes and Blood Glucose on COVID-19 Mortality: A Retrospective Observational Study

Use of Predictive Equations for Energy Prescription Results in Inaccurate Estimation in Trauma Patients

Nutritional therapy in hospital care of in-patients with Covid-19: evidence, consensus and practice guidelines

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