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.

Subject area

Anesthesiology and Intensive Care (The Swedish standard of fields of research 2011)

Keywords

metabolism, amino acids, protein kinetics, icu nutrition

Principal organisation

Karolinska Institutet

Responsible department/unit

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

Data contains personal data

No

Ethics Review

Stockholm — Ref. 2016/76-31/4

Biobank is connected to the study

Yes

Funding

Funding agency: Stockholm County Council

Funding agency’s reference number: 563170

Funding agency: Swedish Research Council

Funding agency’s reference number: 04210

Subject area

Anesthesiology and Intensive Care (The Swedish standard of fields of research 2011)

Keywords

metabolism, amino acids, protein kinetics, icu nutrition

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Version 1

2020-07-01
https://doi.org/10.5878/b1e8-fg58

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

Citation

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

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.

... Show more..

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