Exploring Whether Ventilated ICU Patients Were in Optimal Nutritional Status Regarding Energy and Protein Requirements

Wolter Paans, Willem Dieperink, Rix Groenboom, Talko Dijkhuis, Hildegard Franke

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Abstract

Under- and overfeeding in Intensive Care Units (ICUs) are linked to prolonged hospitalisation, increased morbidity,
and elevated mortality. This study investigates whether ICU patients were optimally nourished according to the European Society
for Clinical Nutrition and Metabolism (ESPEN) guidelines. Methods: A cohort of 158 COVID-19 patients requiring intensive
care for severe respiratory failure, necessitating a nuanced approach to nutritional support, was analysed. Nutritional status was
determined regarding kilocalories and protein using the Energy Expenditure derived from ventilator-measured VCO2 and the
adjusted Weir equation, and data on intake through enteral feeding was used. The study included ventilated patients hospitalised for
over five days without Extra Corporeal Life Support (ECLS) and receiving enteral nutrition. Associations between mortality and
(i) calorie intake and (ii) protein intake were examined using Chi-Square statistics. Results: Conforming to the ESPEN guidelines,
45% of patients were malnourished, and 21% were over-nourished in kilocalories. Additionally, 61% were malnourished, and 16%
were over-nourished in protein. The distribution between the groups of survivors and deceased relative to each of the groups well
nourished, malnourished, and over-nourished was not statistically different (p = 0.21). The protein distribution among survivors and
deceased groups was not statistically different (p = 0.67) regarding correct, insufficient, or excessive protein intake. Conclusions:
Based on ESPEN guidelines, most ICU patients were inadequately nourished in kilocalories and protein. However, no significant
survival differences were observed across groups with varying nutritional adequacy. Further research is recommended to explore the
implications of nutritional interventions in critically ill patients.
Original languageEnglish
Number of pages6
JournalInternational Journal of Nursing and Health Care Research
Volume8
Issue number1
Publication statusPublished - 20 Jan 2025

Keywords

  • nutrition
  • energy expenditure
  • protein intake
  • patient outcomes

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