Can an adequate energy intake be able to reverse the negative nitrogen balance in mechanically ventilated critically ill patients?
Abstract Purpose Adequate energy provision and nitrogen losses prevention of critically ill patients are essentials for treatment and recovery. The aims of this study were to evaluate energy expenditure (EE) and nitrogen balance (NB) of critically ill patients, to classify adequacy of energy intake...
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| Veröffentlicht in: | Journal of critical care 2010-09, Vol.25 (3), p.445-450 |
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| creator | Japur, Camila C., MSc Monteiro, Jacqueline P., PhD Marchini, Júlio Sérgio, PhD Garcia, Rosa Wanda Diez, PhD Basile-Filho, Anibal, PhD |
| description | Abstract Purpose Adequate energy provision and nitrogen losses prevention of critically ill patients are essentials for treatment and recovery. The aims of this study were to evaluate energy expenditure (EE) and nitrogen balance (NB) of critically ill patients, to classify adequacy of energy intake (EI), and to verify adequacy of EI capacity to reverse the negative NB. Methods Seventeen patients from an intensive care unit were evaluated within a 24-hour period. Indirect calorimetry was performed to calculate patient's EE and Kjeldhal for urinary nitrogen analysis. The total EI and protein intake were calculated from the standard parenteral and enteral nutrition infused. Underfeeding was characterized as EI 90% or less and overfeeding as 110% or greater of EE. The adequacy of the EI (EI EE−1 × 100) and the NB were estimated and associated with each other by Spearman coefficient. Results The mean EE was 1515 ± 268 kcal d−1 , and most of the patients (11/14) presented a negative NB (−8.2 ± 4.7 g.d−1 ). A high rate (53%) of inadequate energy intake was found, and a positive correlation between EI EE−1 and NB was observed ( r = 0.670; P = .007). Conclusion The results show a high rate of inadequate EI and negative NB, and equilibrium between EI and EE may improve NB. Indirect calorimetry can be used to adjust the energy requirements in the critically ill patients. |
| doi_str_mv | 10.1016/j.jcrc.2009.05.009 |
| format | Article |
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The aims of this study were to evaluate energy expenditure (EE) and nitrogen balance (NB) of critically ill patients, to classify adequacy of energy intake (EI), and to verify adequacy of EI capacity to reverse the negative NB. Methods Seventeen patients from an intensive care unit were evaluated within a 24-hour period. Indirect calorimetry was performed to calculate patient's EE and Kjeldhal for urinary nitrogen analysis. The total EI and protein intake were calculated from the standard parenteral and enteral nutrition infused. Underfeeding was characterized as EI 90% or less and overfeeding as 110% or greater of EE. The adequacy of the EI (EI EE−1 × 100) and the NB were estimated and associated with each other by Spearman coefficient. Results The mean EE was 1515 ± 268 kcal d−1 , and most of the patients (11/14) presented a negative NB (−8.2 ± 4.7 g.d−1 ). A high rate (53%) of inadequate energy intake was found, and a positive correlation between EI EE−1 and NB was observed ( r = 0.670; P = .007). Conclusion The results show a high rate of inadequate EI and negative NB, and equilibrium between EI and EE may improve NB. Indirect calorimetry can be used to adjust the energy requirements in the critically ill patients.</description><identifier>ISSN: 0883-9441</identifier><identifier>EISSN: 1557-8615</identifier><identifier>DOI: 10.1016/j.jcrc.2009.05.009</identifier><identifier>PMID: 19682853</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Calorimetry, Indirect ; Critical Care ; Critical Illness ; Critically ill patients ; Cross-Sectional Studies ; Dietary Proteins - administration & dosage ; Dietary Proteins - metabolism ; Energy ; Energy expenditure ; Energy Intake ; Energy Metabolism ; Enteral Nutrition ; Female ; Humans ; Indirect calorimetry ; Male ; Metabolism ; Middle Aged ; Nitrogen ; Nitrogen - metabolism ; Nitrogen - urine ; Nitrogen balance ; Nutrition therapy ; Parenteral Nutrition ; Patients ; Proteins ; Respiration, Artificial ; Treatment Outcome</subject><ispartof>Journal of critical care, 2010-09, Vol.25 (3), p.445-450</ispartof><rights>Elsevier Inc.</rights><rights>2010 Elsevier Inc.</rights><rights>Copyright © 2010 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-a25748d0cc8a12cea91120744616afc6032827a468b634f5bcfc5e94bc233f9a3</citedby><cites>FETCH-LOGICAL-c438t-a25748d0cc8a12cea91120744616afc6032827a468b634f5bcfc5e94bc233f9a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1033833642?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976,64364,64366,64368,72218</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19682853$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Japur, Camila C., MSc</creatorcontrib><creatorcontrib>Monteiro, Jacqueline P., PhD</creatorcontrib><creatorcontrib>Marchini, Júlio Sérgio, PhD</creatorcontrib><creatorcontrib>Garcia, Rosa Wanda Diez, PhD</creatorcontrib><creatorcontrib>Basile-Filho, Anibal, PhD</creatorcontrib><title>Can an adequate energy intake be able to reverse the negative nitrogen balance in mechanically ventilated critically ill patients?</title><title>Journal of critical care</title><addtitle>J Crit Care</addtitle><description>Abstract Purpose Adequate energy provision and nitrogen losses prevention of critically ill patients are essentials for treatment and recovery. The aims of this study were to evaluate energy expenditure (EE) and nitrogen balance (NB) of critically ill patients, to classify adequacy of energy intake (EI), and to verify adequacy of EI capacity to reverse the negative NB. Methods Seventeen patients from an intensive care unit were evaluated within a 24-hour period. Indirect calorimetry was performed to calculate patient's EE and Kjeldhal for urinary nitrogen analysis. The total EI and protein intake were calculated from the standard parenteral and enteral nutrition infused. Underfeeding was characterized as EI 90% or less and overfeeding as 110% or greater of EE. The adequacy of the EI (EI EE−1 × 100) and the NB were estimated and associated with each other by Spearman coefficient. Results The mean EE was 1515 ± 268 kcal d−1 , and most of the patients (11/14) presented a negative NB (−8.2 ± 4.7 g.d−1 ). A high rate (53%) of inadequate energy intake was found, and a positive correlation between EI EE−1 and NB was observed ( r = 0.670; P = .007). Conclusion The results show a high rate of inadequate EI and negative NB, and equilibrium between EI and EE may improve NB. Indirect calorimetry can be used to adjust the energy requirements in the critically ill patients.</description><subject>Adult</subject><subject>Aged</subject><subject>Calorimetry, Indirect</subject><subject>Critical Care</subject><subject>Critical Illness</subject><subject>Critically ill patients</subject><subject>Cross-Sectional Studies</subject><subject>Dietary Proteins - administration & dosage</subject><subject>Dietary Proteins - metabolism</subject><subject>Energy</subject><subject>Energy expenditure</subject><subject>Energy Intake</subject><subject>Energy Metabolism</subject><subject>Enteral Nutrition</subject><subject>Female</subject><subject>Humans</subject><subject>Indirect calorimetry</subject><subject>Male</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Nitrogen</subject><subject>Nitrogen - metabolism</subject><subject>Nitrogen - urine</subject><subject>Nitrogen balance</subject><subject>Nutrition therapy</subject><subject>Parenteral Nutrition</subject><subject>Patients</subject><subject>Proteins</subject><subject>Respiration, Artificial</subject><subject>Treatment Outcome</subject><issn>0883-9441</issn><issn>1557-8615</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9Uk1r3DAQNaWl2aT9Az0UQQ892dWnLUNpKEv6AYEe2p6FPB5vtNHaG0le2Gt_eeXuQiCHguAN0nuP0bwpijeMVoyy-sO22kKAilPaVlRVGZ4VK6ZUU-qaqefFimotylZKdlFcxrillDVCqJfFBWtrzbUSq-LP2o5kOT0-zDYhwRHD5kjcmOw9kg6J7TySNJGABwwxl3dIRtzY5A65cClMGxxJZ70dAbOO7BDu7OjAen8kBxyT89m4JxBcOt8678k-O-THeP2qeDFYH_H1Ga-K319ufq2_lbc_vn5ff74tQQqdSstVI3VPAbRlHNC2jHHaSFmz2g5QU8E1b6ysdVcLOagOBlDYyg64EENrxVXx_uS7D9PDjDGZnYuAPjeO0xxNoxTTtJUiM989YW6nOYy5OcOoEFqIWvLM4icWhCnGgIPZB7ez4ZhJZgnIbM0SkFkCMlSZDFn09mw9dzvsHyXnRDLh44mAeRQHh8FEyHMC7F1ASKaf3P_9Pz2Rg3f_wrjHI8bHf5jIDTU_lxVZNoS2eTs4Z-IvPDC3Uw</recordid><startdate>20100901</startdate><enddate>20100901</enddate><creator>Japur, Camila C., MSc</creator><creator>Monteiro, Jacqueline P., PhD</creator><creator>Marchini, Júlio Sérgio, PhD</creator><creator>Garcia, Rosa Wanda Diez, PhD</creator><creator>Basile-Filho, Anibal, PhD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20100901</creationdate><title>Can an adequate energy intake be able to reverse the negative nitrogen balance in mechanically ventilated critically ill patients?</title><author>Japur, Camila C., MSc ; Monteiro, Jacqueline P., PhD ; Marchini, Júlio Sérgio, PhD ; Garcia, Rosa Wanda Diez, PhD ; Basile-Filho, Anibal, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-a25748d0cc8a12cea91120744616afc6032827a468b634f5bcfc5e94bc233f9a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Calorimetry, Indirect</topic><topic>Critical Care</topic><topic>Critical Illness</topic><topic>Critically ill patients</topic><topic>Cross-Sectional Studies</topic><topic>Dietary Proteins - administration & dosage</topic><topic>Dietary Proteins - metabolism</topic><topic>Energy</topic><topic>Energy expenditure</topic><topic>Energy Intake</topic><topic>Energy Metabolism</topic><topic>Enteral Nutrition</topic><topic>Female</topic><topic>Humans</topic><topic>Indirect calorimetry</topic><topic>Male</topic><topic>Metabolism</topic><topic>Middle Aged</topic><topic>Nitrogen</topic><topic>Nitrogen - metabolism</topic><topic>Nitrogen - urine</topic><topic>Nitrogen balance</topic><topic>Nutrition therapy</topic><topic>Parenteral Nutrition</topic><topic>Patients</topic><topic>Proteins</topic><topic>Respiration, Artificial</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Japur, Camila C., MSc</creatorcontrib><creatorcontrib>Monteiro, Jacqueline P., PhD</creatorcontrib><creatorcontrib>Marchini, Júlio Sérgio, PhD</creatorcontrib><creatorcontrib>Garcia, Rosa Wanda Diez, PhD</creatorcontrib><creatorcontrib>Basile-Filho, Anibal, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of critical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Japur, Camila C., MSc</au><au>Monteiro, Jacqueline P., PhD</au><au>Marchini, Júlio Sérgio, PhD</au><au>Garcia, Rosa Wanda Diez, PhD</au><au>Basile-Filho, Anibal, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Can an adequate energy intake be able to reverse the negative nitrogen balance in mechanically ventilated critically ill patients?</atitle><jtitle>Journal of critical care</jtitle><addtitle>J Crit Care</addtitle><date>2010-09-01</date><risdate>2010</risdate><volume>25</volume><issue>3</issue><spage>445</spage><epage>450</epage><pages>445-450</pages><issn>0883-9441</issn><eissn>1557-8615</eissn><abstract>Abstract Purpose Adequate energy provision and nitrogen losses prevention of critically ill patients are essentials for treatment and recovery. The aims of this study were to evaluate energy expenditure (EE) and nitrogen balance (NB) of critically ill patients, to classify adequacy of energy intake (EI), and to verify adequacy of EI capacity to reverse the negative NB. Methods Seventeen patients from an intensive care unit were evaluated within a 24-hour period. Indirect calorimetry was performed to calculate patient's EE and Kjeldhal for urinary nitrogen analysis. The total EI and protein intake were calculated from the standard parenteral and enteral nutrition infused. Underfeeding was characterized as EI 90% or less and overfeeding as 110% or greater of EE. The adequacy of the EI (EI EE−1 × 100) and the NB were estimated and associated with each other by Spearman coefficient. Results The mean EE was 1515 ± 268 kcal d−1 , and most of the patients (11/14) presented a negative NB (−8.2 ± 4.7 g.d−1 ). A high rate (53%) of inadequate energy intake was found, and a positive correlation between EI EE−1 and NB was observed ( r = 0.670; P = .007). Conclusion The results show a high rate of inadequate EI and negative NB, and equilibrium between EI and EE may improve NB. Indirect calorimetry can be used to adjust the energy requirements in the critically ill patients.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>19682853</pmid><doi>10.1016/j.jcrc.2009.05.009</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Aged Calorimetry, Indirect Critical Care Critical Illness Critically ill patients Cross-Sectional Studies Dietary Proteins - administration & dosage Dietary Proteins - metabolism Energy Energy expenditure Energy Intake Energy Metabolism Enteral Nutrition Female Humans Indirect calorimetry Male Metabolism Middle Aged Nitrogen Nitrogen - metabolism Nitrogen - urine Nitrogen balance Nutrition therapy Parenteral Nutrition Patients Proteins Respiration, Artificial Treatment Outcome |
| title | Can an adequate energy intake be able to reverse the negative nitrogen balance in mechanically ventilated critically ill patients? |
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