Effects of normocaloric vs. hypocaloric enteral nutrition on whole-body protein turnover in critically ill patients

Creator/Principal investigator(s):

Olav Rooyackers - Karolinska Institutet

Martin Sundström Rehal - Karolinska Institutet orcid

Description:

Enteral nutrition (EN) is a ubiquitous intervention in ICU patients but there is uncertainty regarding the optimal dose, timing and importance for patient-centered outcomes during critical illness. Our research group has previously found an improved protein balance during normocaloric versus hypocaloric parenteral nutrition in neurosurgical ICU patients. We now wanted to investigate if this could be demonstrated in a general ICU population with established enteral feeding, including patients on renal replacement therapy.

Patients with EN >80% of energy target as determined by indirect calorimetry were randomized to or 50% or 100% of current EN rate. After 24 hours, whole body protein kinetics were determined by enteral and parenteral stable isotope tracer infusions. Treatment allocation was then switched, and tracer investigations repeated 24 hours later in a crossover design with patients serving as their own controls.

Responsible department/unit:

Karolinska Institutet, Anesthesiology and Intensive Care/CLINTEC

Creator/Principal investigator(s):

Olav Rooyackers - Karolinska Institutet

Martin Sundström Rehal - Karolinska Institutet orcid

Contributor(s):

Felix Liebau - Karolinska Institutet

Jan Wernerman - Karolinska Institutet

Identifiers:

SND-ID: SND 1260

Description:

Enteral nutrition (EN) is a ubiquitous intervention in ICU patients but there is uncertainty regarding the optimal dose, timing and importance for patient-centered outcomes during critical illness. Our research group has previously found an improved protein balance during normocaloric versus hypocaloric parenteral nutrition in neurosurgical ICU patients. We now wanted to investigate if this could be demonstrated in a general ICU population with established enteral feeding, including patients on renal replacement therapy.

Patients with EN >80% of energy target as determined by indirect calorimetry were randomized to or 50% or 100% of current EN rate. After 24 hours, whole body protein kinetics were determined by enteral and parenteral stable isotope tracer infusions. Treatment allocation was then switched, and tracer investigations repeated 24 hours later in a crossover design with patients serving as their own controls.

Language:

English

Time period(s) investigated:

2016-12-14 — 2018-03-05

Geographic spread:

Geographic location: Stockholm County

Population:

Adult ICU patients with invasive mechanical ventilation and an FiO2 of =/<0.6.

Study design:

Experimental study

Ethics Review:

Stockholm — Ref. 2016/76-31/4

Biobank is connected to the study:

Yes

Funding:

Stockholm County Council — Ref. 563170

Swedish Research Council — Ref. 04210

Download metadata:

Version 1:

Effects of normocaloric vs. hypocaloric enteral nutrition on whole-body protein turnover in critically ill patients

Suggested citation:

Olav Rooyackers, Martin Sundström Rehal. Karolinska Institutet, Anesthesiology and Intensive Care/CLINTEC (2020). Effects of normocaloric vs. hypocaloric enteral nutrition on whole-body protein turnover in critically ill patients. Swedish National Data Service. Version 1. https://doi.org/10.5878/b1e8-fg58

Creator/Principal investigator(s):

Olav Rooyackers - Karolinska Institutet

Martin Sundström Rehal - Karolinska Institutet orcid

Description:

The files give all data for calculating whole body protein kinetics and the amino acids and urea concentrations at the end of the two 24h intervention periods (day 1 and day 2).

The file "Tracer infusions" gives the details of the preparation of the tracers infused during the two days, including the volumes taken up in the syringes, the dilutions and the final weight of the syringes. All this information is used to calculate the exact rates of infusion in micromol per kg bodyweight per hour.

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Data format / data structure:

Numeric

Data collection:

Mode of collection: Biological tests

Time period(s) for data collection: 2017-02-15 — 2018-03-07

Source of the data: Biological samples

Published: 2020-07-01