Estimation of target proteins achieved in critically ill patients receiving enteral nutrition (EN) and its impact on clinical outcomes


Critical ill patients are susceptible to protein catabolism associated with increased morbidity. This study assesses the target proteins achieved in patients receiving EN & its effect on clinical outcomes in the critically ill.


Retrospective study conducted between January to December 2014 in the ICU of a tertiary care hospital. 47 adult patients in ICU receiving EN for > 3 days were included. The patients were categorized according to percentage of target proteins achieved (Group A >75% & B <75%). Baseline demographics, nutritional status and EN practice parameters were collected and analysed. The length of stay (LOS), ventilator free days and mortality in ICU were evaluated. RESULTS AND DISCUSSION Patients’ mean age was 63 ± 14.8y & body mass index 24.4±4.9. Subjective global assessment revealed that 30(64%) were moderately malnourished & 2(4%) were severely malnourished. An average of 88% & 59% target proteins was achieved in Groups A & B. The average target proteins achieved on the 3rd day was 78% and 50% on the 7th day for Group A. For Group B average target proteins achieved was 56% & 36% on the 3rd & 7th days. Mean feed interruption hours increased to 12.2hours by 7th day. Group B had a higher mean feed initiation time 33.2±40.3hours & interruptions of 35.1±47.5hours when compared with Group A (17.85±29.7 & 11.8±12.7hours). Average LOS & ventilator free days in ICU was less in the Group A (13.9±8.1 & 9.1±7.9). Mortality of 32% observed in Group B where percentage of proteins achieved was least. CONCLUSION Protein metabolism disturbances due to body’s evolutionary metabolic response is observed in the critically ill & negative protein balance secondary to severe disease is associated with poor clinical outcomes. Provision of optimal proteins mitigates protein loss & maybe associated with reduced LOS & mortality in the ICU & thereby improved health care costs.