第46回日本集中治療医学会学術集会

Presentation information

English Session

[EngO5] English Session5

Sat. Mar 2, 2019 10:55 AM - 11:55 AM 第11会場 (国立京都国際会館1F Room C-2)

Chair:Hideo Inaba(Department of Circulatory Emergency and Resuscitation Science, Kanazawa University Graduate School of Medicine, Japan)

[EngO5-1] Feeding practices of mechanically ventilated intensive care patients: an evaluation of overfeeding and clinical outcomes

Aiko Tanaka1,2, Kate Hamilton3, Glenn Eastwood2, Daryl Jones2, Rinaldo Bellomo2 (1.Department of Anesthesiology and Intensive Care Medicine, Osaka University, Japan, 2.Department of Intensive Care, Austin Hospital, Australia, 3.Nutrition and Dietetic Department, Austin Hospital, Australia)

Critically ill patients are at high risk of malnutrition. Overfeeding critically ill patients has significant clinical consequences. This study aimed to assess for the frequency and consequence of potential overfeeding in ICU patients mechanically ventilated (MV) for at least 10 days.
Methods: Retrospective analysis of 105 MV patients was performed, including calorie delivery, estimated caloric requirements, and association between caloric delivery and several pre-defined clinical outcomes. To increase likelihood of detecting overfeeding, we conducted sensitivity analysis for a subgroup patient who received on average < 25kcal/kg/day and ≥ 25 kcal/kg/day between day 7-10 and performed repeated measure ANOVA.
Results: 55 patients were received an average of < 25kcal/kg/day, and 50 received ≥ 25 kcal/kg/day. The latter group was younger, less weighed and with fewer patients with ischemic heart failure. Higher caloric delivery was statistically associated with increased minute ventilation (p<0.001). Higher caloric delivery was also associated with more frequent diarrhea (p=0.01) and higher alkaline phosphatase level (p=0.02). However, these differences did not translate into increased duration of mechanical ventilation, length of stay, or increased mortality.
Conclusions: Higher caloric delivery was associated with increased minute ventilation, diarrhea and liver function. The effect of such physiological end-points on patient centered outcomes require further investigation.