Improvement in Protein Delivery for Critically Ill Patients Requiring High‐Dose Propofol Therapy and Enteral Nutrition
Background Patients with traumatic brain (TBI) injury often require a high dosage of propofol, which can provide an excessive caloric intake. We evaluated our strategy of using liquid protein supplement boluses concurrently with high protein–containing enteral nutrition (EN) formulas and formula rat...
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| Veröffentlicht in: | Nutrition in clinical practice 2021-02, Vol.36 (1), p.212-218 |
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| creator | Buckley, Christopher T. Van Matre, Edward T. Fischer, Peter E. Minard, Gayle Dickerson, Roland N. |
| description | Background
Patients with traumatic brain (TBI) injury often require a high dosage of propofol, which can provide an excessive caloric intake. We evaluated our strategy of using liquid protein supplement boluses concurrently with high protein–containing enteral nutrition (EN) formulas and formula rate reduction to avoid caloric overfeeding and inadequate protein intake.
Methods
Adult patients (aged >17 years) with TBI admitted to the trauma intensive care unit (TICU) who received concurrent propofol and EN were retrospectively reviewed. Caloric intakes from propofol and EN were obtained. Actual protein intake was compared with projected protein intakes from high protein content and standard protein content enteral formulas when given at an isocaloric intake.
Results
Fifty‐one patients were enrolled. Average caloric intake from propofol was 356 ± 243 kcal/d or 5 ± 3 kcal/kg/d (range, |
| doi_str_mv | 10.1002/ncp.10546 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_webof</sourceid><recordid>TN_cdi_webofscience_primary_000543236100001</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2418128850</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3256-35d3bed9c8786f6f8835fd9b6a51f0ca7ed7a48aaa37cb4a79cc0c07407b4c3b3</originalsourceid><addsrcrecordid>eNqNkc1u1DAURi0EokNhwQsgL0Eo1I7z4yxRWuhIVRmhso4c57o1cuzUdkqz6yPwjDxJPZ1pd0hdXVs69-jzZ4TeU_KFEpIfWTmlQ1lUL9CKNgXN8qLMX6IV4bzISsaqA_QmhN-EUM5q_hodsLzkDadkhW7X4-TdDYxgI9YWb7yLkOYxGH0DfsHKedx6HbUUxix4bQzeiKgTHvBPuJ611_YSn-rLq393f49dgK1icsoZfHEFXkwLFnbAJzami8Hnc9zKnH2LXilhArzbz0P069vJRXuanf34vm6_nmUyhawyVg6sh6GRvOaVqhTnrFRD01eipIpIUcNQi4ILIVgt-0LUjZREkrogdV9I1rND9HHnTc-8niHEbtRBgjHCgptDlxeU05zzkiT00w6V3oXgQXWT16PwS0dJty26S0V3D0Un9sNeO_cjDE_kY7MJ4DvgD_ROBZkak_CEEZIsLGdV0qZvaXUU21JaN9uYVj8_fzXRR3taG1j-H7k7bze77PdltatG</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2418128850</pqid></control><display><type>article</type><title>Improvement in Protein Delivery for Critically Ill Patients Requiring High‐Dose Propofol Therapy and Enteral Nutrition</title><source>Access via Wiley Online Library</source><source>Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><creator>Buckley, Christopher T. ; Van Matre, Edward T. ; Fischer, Peter E. ; Minard, Gayle ; Dickerson, Roland N.</creator><creatorcontrib>Buckley, Christopher T. ; Van Matre, Edward T. ; Fischer, Peter E. ; Minard, Gayle ; Dickerson, Roland N.</creatorcontrib><description>Background
Patients with traumatic brain (TBI) injury often require a high dosage of propofol, which can provide an excessive caloric intake. We evaluated our strategy of using liquid protein supplement boluses concurrently with high protein–containing enteral nutrition (EN) formulas and formula rate reduction to avoid caloric overfeeding and inadequate protein intake.
Methods
Adult patients (aged >17 years) with TBI admitted to the trauma intensive care unit (TICU) who received concurrent propofol and EN were retrospectively reviewed. Caloric intakes from propofol and EN were obtained. Actual protein intake was compared with projected protein intakes from high protein content and standard protein content enteral formulas when given at an isocaloric intake.
Results
Fifty‐one patients were enrolled. Average caloric intake from propofol was 356 ± 243 kcal/d or 5 ± 3 kcal/kg/d (range, <1–15 kcal/kg/d). Daily EN caloric intake ranged from 7 ± 4 kcal/kg/d (day 2) to 16 ± 9 kcal/kg/d (day 5; P < .001). Average protein intake ranged from 0.6 ± 0.4 g/kg/d (day 2) to 1.5 ± 0.7 g/kg/d (day 5; P < .001). The modified EN strategy resulted in daily delivery of 24%–38% more protein than an isocaloric regimen with a high protein–content formula and twice as much protein than the standard protein–content formula (P < .001).
Conclusion
The strategy of providing an EN regimen comprised liquid protein boluses, and high and very high protein–containing EN formulas at a reduced rate improved protein delivery without caloric overfeeding.</description><identifier>ISSN: 0884-5336</identifier><identifier>EISSN: 1941-2452</identifier><identifier>DOI: 10.1002/ncp.10546</identifier><identifier>PMID: 32589810</identifier><language>eng</language><publisher>HOBOKEN: Wiley</publisher><subject>calorie ; critical illness ; enteral nutrition ; Life Sciences & Biomedicine ; Nursing ; Nutrition & Dietetics ; propofol ; protein ; Science & Technology ; traumatic brain injury</subject><ispartof>Nutrition in clinical practice, 2021-02, Vol.36 (1), p.212-218</ispartof><rights>2020 American Society for Parenteral and Enteral Nutrition</rights><rights>2020 American Society for Parenteral and Enteral Nutrition.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>8</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000543236100001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c3256-35d3bed9c8786f6f8835fd9b6a51f0ca7ed7a48aaa37cb4a79cc0c07407b4c3b3</citedby><cites>FETCH-LOGICAL-c3256-35d3bed9c8786f6f8835fd9b6a51f0ca7ed7a48aaa37cb4a79cc0c07407b4c3b3</cites><orcidid>0000-0003-2398-2273 ; 0000-0002-2086-6317 ; 0000-0001-9125-9509</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fncp.10546$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fncp.10546$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,782,786,1419,27931,27932,39265,45581,45582</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32589810$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Buckley, Christopher T.</creatorcontrib><creatorcontrib>Van Matre, Edward T.</creatorcontrib><creatorcontrib>Fischer, Peter E.</creatorcontrib><creatorcontrib>Minard, Gayle</creatorcontrib><creatorcontrib>Dickerson, Roland N.</creatorcontrib><title>Improvement in Protein Delivery for Critically Ill Patients Requiring High‐Dose Propofol Therapy and Enteral Nutrition</title><title>Nutrition in clinical practice</title><addtitle>NUTR CLIN PRACT</addtitle><addtitle>Nutr Clin Pract</addtitle><description>Background
Patients with traumatic brain (TBI) injury often require a high dosage of propofol, which can provide an excessive caloric intake. We evaluated our strategy of using liquid protein supplement boluses concurrently with high protein–containing enteral nutrition (EN) formulas and formula rate reduction to avoid caloric overfeeding and inadequate protein intake.
Methods
Adult patients (aged >17 years) with TBI admitted to the trauma intensive care unit (TICU) who received concurrent propofol and EN were retrospectively reviewed. Caloric intakes from propofol and EN were obtained. Actual protein intake was compared with projected protein intakes from high protein content and standard protein content enteral formulas when given at an isocaloric intake.
Results
Fifty‐one patients were enrolled. Average caloric intake from propofol was 356 ± 243 kcal/d or 5 ± 3 kcal/kg/d (range, <1–15 kcal/kg/d). Daily EN caloric intake ranged from 7 ± 4 kcal/kg/d (day 2) to 16 ± 9 kcal/kg/d (day 5; P < .001). Average protein intake ranged from 0.6 ± 0.4 g/kg/d (day 2) to 1.5 ± 0.7 g/kg/d (day 5; P < .001). The modified EN strategy resulted in daily delivery of 24%–38% more protein than an isocaloric regimen with a high protein–content formula and twice as much protein than the standard protein–content formula (P < .001).
Conclusion
The strategy of providing an EN regimen comprised liquid protein boluses, and high and very high protein–containing EN formulas at a reduced rate improved protein delivery without caloric overfeeding.</description><subject>calorie</subject><subject>critical illness</subject><subject>enteral nutrition</subject><subject>Life Sciences & Biomedicine</subject><subject>Nursing</subject><subject>Nutrition & Dietetics</subject><subject>propofol</subject><subject>protein</subject><subject>Science & Technology</subject><subject>traumatic brain injury</subject><issn>0884-5336</issn><issn>1941-2452</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><recordid>eNqNkc1u1DAURi0EokNhwQsgL0Eo1I7z4yxRWuhIVRmhso4c57o1cuzUdkqz6yPwjDxJPZ1pd0hdXVs69-jzZ4TeU_KFEpIfWTmlQ1lUL9CKNgXN8qLMX6IV4bzISsaqA_QmhN-EUM5q_hodsLzkDadkhW7X4-TdDYxgI9YWb7yLkOYxGH0DfsHKedx6HbUUxix4bQzeiKgTHvBPuJ611_YSn-rLq393f49dgK1icsoZfHEFXkwLFnbAJzami8Hnc9zKnH2LXilhArzbz0P069vJRXuanf34vm6_nmUyhawyVg6sh6GRvOaVqhTnrFRD01eipIpIUcNQi4ILIVgt-0LUjZREkrogdV9I1rND9HHnTc-8niHEbtRBgjHCgptDlxeU05zzkiT00w6V3oXgQXWT16PwS0dJty26S0V3D0Un9sNeO_cjDE_kY7MJ4DvgD_ROBZkak_CEEZIsLGdV0qZvaXUU21JaN9uYVj8_fzXRR3taG1j-H7k7bze77PdltatG</recordid><startdate>202102</startdate><enddate>202102</enddate><creator>Buckley, Christopher T.</creator><creator>Van Matre, Edward T.</creator><creator>Fischer, Peter E.</creator><creator>Minard, Gayle</creator><creator>Dickerson, Roland N.</creator><general>Wiley</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2398-2273</orcidid><orcidid>https://orcid.org/0000-0002-2086-6317</orcidid><orcidid>https://orcid.org/0000-0001-9125-9509</orcidid></search><sort><creationdate>202102</creationdate><title>Improvement in Protein Delivery for Critically Ill Patients Requiring High‐Dose Propofol Therapy and Enteral Nutrition</title><author>Buckley, Christopher T. ; Van Matre, Edward T. ; Fischer, Peter E. ; Minard, Gayle ; Dickerson, Roland N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3256-35d3bed9c8786f6f8835fd9b6a51f0ca7ed7a48aaa37cb4a79cc0c07407b4c3b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>calorie</topic><topic>critical illness</topic><topic>enteral nutrition</topic><topic>Life Sciences & Biomedicine</topic><topic>Nursing</topic><topic>Nutrition & Dietetics</topic><topic>propofol</topic><topic>protein</topic><topic>Science & Technology</topic><topic>traumatic brain injury</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Buckley, Christopher T.</creatorcontrib><creatorcontrib>Van Matre, Edward T.</creatorcontrib><creatorcontrib>Fischer, Peter E.</creatorcontrib><creatorcontrib>Minard, Gayle</creatorcontrib><creatorcontrib>Dickerson, Roland N.</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Nutrition in clinical practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Buckley, Christopher T.</au><au>Van Matre, Edward T.</au><au>Fischer, Peter E.</au><au>Minard, Gayle</au><au>Dickerson, Roland N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improvement in Protein Delivery for Critically Ill Patients Requiring High‐Dose Propofol Therapy and Enteral Nutrition</atitle><jtitle>Nutrition in clinical practice</jtitle><stitle>NUTR CLIN PRACT</stitle><addtitle>Nutr Clin Pract</addtitle><date>2021-02</date><risdate>2021</risdate><volume>36</volume><issue>1</issue><spage>212</spage><epage>218</epage><pages>212-218</pages><issn>0884-5336</issn><eissn>1941-2452</eissn><abstract>Background
Patients with traumatic brain (TBI) injury often require a high dosage of propofol, which can provide an excessive caloric intake. We evaluated our strategy of using liquid protein supplement boluses concurrently with high protein–containing enteral nutrition (EN) formulas and formula rate reduction to avoid caloric overfeeding and inadequate protein intake.
Methods
Adult patients (aged >17 years) with TBI admitted to the trauma intensive care unit (TICU) who received concurrent propofol and EN were retrospectively reviewed. Caloric intakes from propofol and EN were obtained. Actual protein intake was compared with projected protein intakes from high protein content and standard protein content enteral formulas when given at an isocaloric intake.
Results
Fifty‐one patients were enrolled. Average caloric intake from propofol was 356 ± 243 kcal/d or 5 ± 3 kcal/kg/d (range, <1–15 kcal/kg/d). Daily EN caloric intake ranged from 7 ± 4 kcal/kg/d (day 2) to 16 ± 9 kcal/kg/d (day 5; P < .001). Average protein intake ranged from 0.6 ± 0.4 g/kg/d (day 2) to 1.5 ± 0.7 g/kg/d (day 5; P < .001). The modified EN strategy resulted in daily delivery of 24%–38% more protein than an isocaloric regimen with a high protein–content formula and twice as much protein than the standard protein–content formula (P < .001).
Conclusion
The strategy of providing an EN regimen comprised liquid protein boluses, and high and very high protein–containing EN formulas at a reduced rate improved protein delivery without caloric overfeeding.</abstract><cop>HOBOKEN</cop><pub>Wiley</pub><pmid>32589810</pmid><doi>10.1002/ncp.10546</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-2398-2273</orcidid><orcidid>https://orcid.org/0000-0002-2086-6317</orcidid><orcidid>https://orcid.org/0000-0001-9125-9509</orcidid></addata></record> |
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| subjects | calorie critical illness enteral nutrition Life Sciences & Biomedicine Nursing Nutrition & Dietetics propofol protein Science & Technology traumatic brain injury |
| title | Improvement in Protein Delivery for Critically Ill Patients Requiring High‐Dose Propofol Therapy and Enteral Nutrition |
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