The Impact Of Indirect Calorimetry Guided Feeding Protocol On Clinical Outcomes In Critically Ill Patients: A Randomized Controlled Trial (The Ic Study)

• Main Authors: Mat Nor, Mohd Basri, Samiullah, Saeed, Md Ralib, Azrina, Mohamad Aidid, Edre
• Format: Conference or Workshop Item
• Language: English
• Published: IIUM Press 2021
• Subjects: RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid
• Online Access: http://irep.iium.edu.my/91493/1/91493_The%20Impact%20Of%20Indirect%20Calorimetry%20Guided%20Feeding%20Protocol.pdf; http://irep.iium.edu.my/91493/; https://journals.iium.edu.my/ijahs/index.php/IJAHS/article/view/583
• Institution: Universiti Islam Antarabangsa Malaysia

Background: International guidelines recommend the use of indirect calorimetry (IC) to measure energy requirements in critically ill patients. This study aimed to assess the effects of IC-guided nutrition vs standard-nutrition care on clinical outcomes in critically ill patients. Methods: Sixty mechanically ventilated patients expected to stay in intensive care unit (ICU) more than 3 days were randomized into a group in which energy needs were determined by IC (IC-group) and a group prescribed with 25kcal/kg/day reflecting standard care (SC-group). The primary outcome was the ICU length of stay(LOS). Secondary outcomes included change in quadriceps muscle layer thickness (QMLT, ultrasound) during the first 10 days of ICU admission, hospital-LOS, duration of mechanical ventilation, ICU mortality and 28-day-in hospital mortality. Results: Mean energy requirement was similar in both groups. The IC group received 85.63%, whereas the SC group received 76.83% of their energy goals (P=0.002). The protein intake was higher in the IC group (89.58% vs 77.66%, p=0.007). Both groups had a median of 8.0 days ICU-LOS (p=0.424). QMLT was decreased in both groups by 21.9% vs. 25.3% at day10 (p < 0.001), respectively. However, there were no significant differences observed in muscle mass changes and other secondary clinical outcomes between the groups. Conclusion: IC-guided nutrition did not appear to affect significantly any clinical outcomes compared to the SC group due to the limitation in Sample size. Clinicaltrials.gov identifier no. NCT04479254