Hypocaloric enteral tube feeding in critically III obese patients

Roland Dickerson, Kathryn J. Boschert, Kenneth A. Kudsk, Rex Brown

Research output: Contribution to journalArticle

199 Citations (Scopus)

Abstract

OBJECTIVE: We respectively compared the nutritional and clinical efficacies of eucaloric and hypocaloric enteral feedings in 40 critically ill, obese patients admitted to the trauma or surgical intensive care unit. METHODS: Adult patients, 18 to 69 years old, with weights greater than 125% of ideal body weight, normal renal and hepatic functions, and who received at least 7 d of enteral tube feeding were studied. Patients were stratified according to feeding group: eucaloric feeding (≥20 kcal/kg of adjusted weight per day; n = 12) or hypocaloric feeding (<20 kcal/kg of adjusted weight per day; n = 28). The goal protein intake for both groups was approximately 2 g/kg of ideal body weight per day. Clinical events and nutrition data were recorded for 4 wk. RESULTS: Patients were similar according to sex, age, weight, body mass index, Second Acute Physiology and Chronic Health Evaluation score, Trauma score, and Injury Severity Score. The hypocaloric feeding group received significantly fewer calories than the eucaloric group (P ≤ 0.05). The hypocaloric group had a shorter stay in the intensive care unit (18.6 ± 9.9 d versus 28.5 ± 16.1 d, P < 0.03), decreased duration of antibiotic therapy days (16.6 ± 11.7 d versus 27.4 ± 17.3 d, P < 0.03), and a trend toward a decrease in days of mechanical ventilation (15.9 ± 10.8 d versus 23.7 ± 16.6 d, P = 0.09). There was no statistically significant difference in nitrogen balance or serum prealbumin response between groups. CONCLUSION: These data suggest that hypocaloric enteral nutrition support is as least as effective as eucaloric feeding in critically ill, obese patients.

Original languageEnglish (US)
Pages (from-to)241-246
Number of pages6
JournalNutrition
Volume18
Issue number3
DOIs
StatePublished - Mar 19 2002

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Enteral Nutrition
Weights and Measures
Ideal Body Weight
Critical Illness
Intensive Care Units
Injury Severity Score
APACHE
Prealbumin
Wounds and Injuries
Critical Care
Artificial Respiration
Body Mass Index
Nitrogen
Anti-Bacterial Agents
Kidney
Liver
Serum
Proteins

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Surgery

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Hypocaloric enteral tube feeding in critically III obese patients. / Dickerson, Roland; Boschert, Kathryn J.; Kudsk, Kenneth A.; Brown, Rex.

In: Nutrition, Vol. 18, No. 3, 19.03.2002, p. 241-246.

Research output: Contribution to journalArticle

Dickerson, Roland ; Boschert, Kathryn J. ; Kudsk, Kenneth A. ; Brown, Rex. / Hypocaloric enteral tube feeding in critically III obese patients. In: Nutrition. 2002 ; Vol. 18, No. 3. pp. 241-246.
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N2 - OBJECTIVE: We respectively compared the nutritional and clinical efficacies of eucaloric and hypocaloric enteral feedings in 40 critically ill, obese patients admitted to the trauma or surgical intensive care unit. METHODS: Adult patients, 18 to 69 years old, with weights greater than 125% of ideal body weight, normal renal and hepatic functions, and who received at least 7 d of enteral tube feeding were studied. Patients were stratified according to feeding group: eucaloric feeding (≥20 kcal/kg of adjusted weight per day; n = 12) or hypocaloric feeding (<20 kcal/kg of adjusted weight per day; n = 28). The goal protein intake for both groups was approximately 2 g/kg of ideal body weight per day. Clinical events and nutrition data were recorded for 4 wk. RESULTS: Patients were similar according to sex, age, weight, body mass index, Second Acute Physiology and Chronic Health Evaluation score, Trauma score, and Injury Severity Score. The hypocaloric feeding group received significantly fewer calories than the eucaloric group (P ≤ 0.05). The hypocaloric group had a shorter stay in the intensive care unit (18.6 ± 9.9 d versus 28.5 ± 16.1 d, P < 0.03), decreased duration of antibiotic therapy days (16.6 ± 11.7 d versus 27.4 ± 17.3 d, P < 0.03), and a trend toward a decrease in days of mechanical ventilation (15.9 ± 10.8 d versus 23.7 ± 16.6 d, P = 0.09). There was no statistically significant difference in nitrogen balance or serum prealbumin response between groups. CONCLUSION: These data suggest that hypocaloric enteral nutrition support is as least as effective as eucaloric feeding in critically ill, obese patients.

AB - OBJECTIVE: We respectively compared the nutritional and clinical efficacies of eucaloric and hypocaloric enteral feedings in 40 critically ill, obese patients admitted to the trauma or surgical intensive care unit. METHODS: Adult patients, 18 to 69 years old, with weights greater than 125% of ideal body weight, normal renal and hepatic functions, and who received at least 7 d of enteral tube feeding were studied. Patients were stratified according to feeding group: eucaloric feeding (≥20 kcal/kg of adjusted weight per day; n = 12) or hypocaloric feeding (<20 kcal/kg of adjusted weight per day; n = 28). The goal protein intake for both groups was approximately 2 g/kg of ideal body weight per day. Clinical events and nutrition data were recorded for 4 wk. RESULTS: Patients were similar according to sex, age, weight, body mass index, Second Acute Physiology and Chronic Health Evaluation score, Trauma score, and Injury Severity Score. The hypocaloric feeding group received significantly fewer calories than the eucaloric group (P ≤ 0.05). The hypocaloric group had a shorter stay in the intensive care unit (18.6 ± 9.9 d versus 28.5 ± 16.1 d, P < 0.03), decreased duration of antibiotic therapy days (16.6 ± 11.7 d versus 27.4 ± 17.3 d, P < 0.03), and a trend toward a decrease in days of mechanical ventilation (15.9 ± 10.8 d versus 23.7 ± 16.6 d, P = 0.09). There was no statistically significant difference in nitrogen balance or serum prealbumin response between groups. CONCLUSION: These data suggest that hypocaloric enteral nutrition support is as least as effective as eucaloric feeding in critically ill, obese patients.

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