Clinical Dietitian, Dietetic Service, Mackay Memorial Hospital
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Mackay Memorial Hospital
- Enrollment
- 190
- Locations
- 1
- Primary Endpoint
- Determination of the energy requirements in critically ill elderly patients
Study Overview
Brief Summary
The purposes of this study were to investigate the caloric requirement and clinical outcomes in mechanically ventilated critically ill elderly patients and identify those at high nutritional risk who require high protein formula intervention.
Detailed Description
The elderly population is rapidly increasing, but studies on calorie requirement in critically ill elderly patients are few, and indirect calorimetry (IC) is not available in every intensive care unit (ICU). The aim of this study was to compare IC and Harris-Benedict (HB) predictive equation in different BMI (body mass index) groups. And to investigate whether the nutrition intake from EN (enteral nutrition) and PN (parenteral nutrition) created a better clinical outcome than EN alone in HNR (high nutritional risk) mechanically ventilated critically ill elderly patients.Inclusion criteria were: age ≧65 years old, APACHE Π score ≧15, mechanical ventilation ≧48 hours and on NG tube feeding. Nutritional risk was screened by mNUTRIC and GNRI. Indirect calorimetry and HB equation were used to assess energy requirements. Patients were randomized 1:1 to two tube feeding regimens: general formula and high protein formula (1.5~2.0 gm/kg BW). Nutritional intake from EN, the type and amount of intravenous nutrition within 7 days, tolerance to feeding, MVD (Mechanical Ventilation Day), newly diagnosed VAP (Ventilator Associated Pneumonia), ICU and hospital LOS (Length of Stay) and date of death were recorded. We used SAS version 9.4 for statistical analysis. Statistically significance was set at α=0.05.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Supportive Care
- Masking
- None
Eligibility Criteria
- Ages
- 65 Years to — (Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •APACHE Π score ≧ 15
- •≧ 65 years
- •on mechanical ventilation ≧48 hours
- •received EN
Exclusion Criteria
- •Use of total parenteral nutrition
- •Fasting >5 days
- •Brain death
- •Terminal cancer
Arms & Interventions
high protein enteral nutrition
supply protein over 1.5 gm/kg body weight
Intervention: high protein enteral nutrition (Dietary Supplement)
Outcomes
Primary Outcomes
Determination of the energy requirements in critically ill elderly patients
Time Frame: first 5 days in the ICU
A total of 177 critically ill elderly patients (≧ 65 years old) underwent IC for measured resting energy expenditure (MREE). Estimated calorie requirement was calculated by the HB equation, using actual body weight (ABW) and ideal body weight (IBW) separately. Patients were divided into four BMI groups. One-way ANOVA and Pearson's correlation coefficient were used for statistical analyses.
Secondary Outcomes
- Higher Enteral Nutrition Intake May Reduce Hospital Mortality(first 28 days in the ICU)
Investigators
Pi-Hui Hsu
Dietitian, Dietetic service
Mackay Memorial Hospital