Procalcitonin and enteral nutrition tolerance in critically ill patients

Rex Brown, Earnest Alexander, Scott D. Hanes, G Christopher Wood, Kenneth A. Kudsk, Roland Dickerson

Research output: Contribution to journalArticle

Abstract

Background: Serum procalcitonin concentrations have been reported to be elevated in patients with bacterial infection. Early enteral nutrition (EN) has been shown to decrease infections in trauma patients. The purpose of this study was to characterize procalcitonin and other serum proteins during EN of trauma patients based on EN tolerance and presence of infection. Methods: Twenty traumatized patients received a high-protein enteral formulation within 5 days of injury. Serum for procalcitonin, C-reactive protein, and prealbumin was analyzed on days 1 and 7 of EN. The procalcitonin/prealbumin and C-reactive protein/prealbumin ratios were calculated the same days. Patients who were infected during the study were compared with those not infected, and enteral-tolerant patients were compared with enteral-intolerant patients using these measurements. Results: In the 20 trauma patients, procalcitonin (10.35 ± 27.87 versus 1.03 ± 1.24 ng/mL, p <.001) and procalcitonin/prealbumin ratio (1.70 ± 4.20 versus 0.18 ± 0.28, p <.01) decreased significantly over the 7-day period of EN. In the 12 patients who had infection, procalcitonin (16.33 ± 35.31 versus 1.37 ± 1.41 ng/mL, p <.004) and procalcitonin/prealbumin ratio (2.74 ± 5.31 versus 0.26 ± 0.33, p <.01) decreased significantly over the 7-day period of enteral nutrition. There were no significant changes in the measurements for 8 patients without infection. In the 15 patients who were enteral-tolerant, procalcitonin (12.56 ± 32.84 versus 1.07 ± 1.23 ng/mL, p <.004) and procalcitonin/prealbumin ratio (2.03 ± 4.93 versus 0.20 ± 0.29, p <.01) decreased significantly. Conclusion: Procalcitonin serum concentrations decrease significantly during EN in enteral-tolerant, critically ill patients with infection.

Original languageEnglish (US)
Pages (from-to)84-88
Number of pages5
JournalJournal of Parenteral and Enteral Nutrition
Volume27
Issue number1
DOIs
StatePublished - Jan 1 2003

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Calcitonin
Enteral Nutrition
Critical Illness
Prealbumin
Small Intestine
Infection
Wounds and Injuries
C-Reactive Protein
Serum
Bacterial Infections
Blood Proteins

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Procalcitonin and enteral nutrition tolerance in critically ill patients. / Brown, Rex; Alexander, Earnest; Hanes, Scott D.; Wood, G Christopher; Kudsk, Kenneth A.; Dickerson, Roland.

In: Journal of Parenteral and Enteral Nutrition, Vol. 27, No. 1, 01.01.2003, p. 84-88.

Research output: Contribution to journalArticle

Brown, Rex ; Alexander, Earnest ; Hanes, Scott D. ; Wood, G Christopher ; Kudsk, Kenneth A. ; Dickerson, Roland. / Procalcitonin and enteral nutrition tolerance in critically ill patients. In: Journal of Parenteral and Enteral Nutrition. 2003 ; Vol. 27, No. 1. pp. 84-88.
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abstract = "Background: Serum procalcitonin concentrations have been reported to be elevated in patients with bacterial infection. Early enteral nutrition (EN) has been shown to decrease infections in trauma patients. The purpose of this study was to characterize procalcitonin and other serum proteins during EN of trauma patients based on EN tolerance and presence of infection. Methods: Twenty traumatized patients received a high-protein enteral formulation within 5 days of injury. Serum for procalcitonin, C-reactive protein, and prealbumin was analyzed on days 1 and 7 of EN. The procalcitonin/prealbumin and C-reactive protein/prealbumin ratios were calculated the same days. Patients who were infected during the study were compared with those not infected, and enteral-tolerant patients were compared with enteral-intolerant patients using these measurements. Results: In the 20 trauma patients, procalcitonin (10.35 ± 27.87 versus 1.03 ± 1.24 ng/mL, p <.001) and procalcitonin/prealbumin ratio (1.70 ± 4.20 versus 0.18 ± 0.28, p <.01) decreased significantly over the 7-day period of EN. In the 12 patients who had infection, procalcitonin (16.33 ± 35.31 versus 1.37 ± 1.41 ng/mL, p <.004) and procalcitonin/prealbumin ratio (2.74 ± 5.31 versus 0.26 ± 0.33, p <.01) decreased significantly over the 7-day period of enteral nutrition. There were no significant changes in the measurements for 8 patients without infection. In the 15 patients who were enteral-tolerant, procalcitonin (12.56 ± 32.84 versus 1.07 ± 1.23 ng/mL, p <.004) and procalcitonin/prealbumin ratio (2.03 ± 4.93 versus 0.20 ± 0.29, p <.01) decreased significantly. Conclusion: Procalcitonin serum concentrations decrease significantly during EN in enteral-tolerant, critically ill patients with infection.",
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T1 - Procalcitonin and enteral nutrition tolerance in critically ill patients

AU - Brown, Rex

AU - Alexander, Earnest

AU - Hanes, Scott D.

AU - Wood, G Christopher

AU - Kudsk, Kenneth A.

AU - Dickerson, Roland

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N2 - Background: Serum procalcitonin concentrations have been reported to be elevated in patients with bacterial infection. Early enteral nutrition (EN) has been shown to decrease infections in trauma patients. The purpose of this study was to characterize procalcitonin and other serum proteins during EN of trauma patients based on EN tolerance and presence of infection. Methods: Twenty traumatized patients received a high-protein enteral formulation within 5 days of injury. Serum for procalcitonin, C-reactive protein, and prealbumin was analyzed on days 1 and 7 of EN. The procalcitonin/prealbumin and C-reactive protein/prealbumin ratios were calculated the same days. Patients who were infected during the study were compared with those not infected, and enteral-tolerant patients were compared with enteral-intolerant patients using these measurements. Results: In the 20 trauma patients, procalcitonin (10.35 ± 27.87 versus 1.03 ± 1.24 ng/mL, p <.001) and procalcitonin/prealbumin ratio (1.70 ± 4.20 versus 0.18 ± 0.28, p <.01) decreased significantly over the 7-day period of EN. In the 12 patients who had infection, procalcitonin (16.33 ± 35.31 versus 1.37 ± 1.41 ng/mL, p <.004) and procalcitonin/prealbumin ratio (2.74 ± 5.31 versus 0.26 ± 0.33, p <.01) decreased significantly over the 7-day period of enteral nutrition. There were no significant changes in the measurements for 8 patients without infection. In the 15 patients who were enteral-tolerant, procalcitonin (12.56 ± 32.84 versus 1.07 ± 1.23 ng/mL, p <.004) and procalcitonin/prealbumin ratio (2.03 ± 4.93 versus 0.20 ± 0.29, p <.01) decreased significantly. Conclusion: Procalcitonin serum concentrations decrease significantly during EN in enteral-tolerant, critically ill patients with infection.

AB - Background: Serum procalcitonin concentrations have been reported to be elevated in patients with bacterial infection. Early enteral nutrition (EN) has been shown to decrease infections in trauma patients. The purpose of this study was to characterize procalcitonin and other serum proteins during EN of trauma patients based on EN tolerance and presence of infection. Methods: Twenty traumatized patients received a high-protein enteral formulation within 5 days of injury. Serum for procalcitonin, C-reactive protein, and prealbumin was analyzed on days 1 and 7 of EN. The procalcitonin/prealbumin and C-reactive protein/prealbumin ratios were calculated the same days. Patients who were infected during the study were compared with those not infected, and enteral-tolerant patients were compared with enteral-intolerant patients using these measurements. Results: In the 20 trauma patients, procalcitonin (10.35 ± 27.87 versus 1.03 ± 1.24 ng/mL, p <.001) and procalcitonin/prealbumin ratio (1.70 ± 4.20 versus 0.18 ± 0.28, p <.01) decreased significantly over the 7-day period of EN. In the 12 patients who had infection, procalcitonin (16.33 ± 35.31 versus 1.37 ± 1.41 ng/mL, p <.004) and procalcitonin/prealbumin ratio (2.74 ± 5.31 versus 0.26 ± 0.33, p <.01) decreased significantly over the 7-day period of enteral nutrition. There were no significant changes in the measurements for 8 patients without infection. In the 15 patients who were enteral-tolerant, procalcitonin (12.56 ± 32.84 versus 1.07 ± 1.23 ng/mL, p <.004) and procalcitonin/prealbumin ratio (2.03 ± 4.93 versus 0.20 ± 0.29, p <.01) decreased significantly. Conclusion: Procalcitonin serum concentrations decrease significantly during EN in enteral-tolerant, critically ill patients with infection.

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