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Hypocaloric compared with eucaloric nutritional support and its effect on infection rates in a surgical intensive care unit: a randomized controlled trial.

Publication ,  Journal Article
Charles, EJ; Petroze, RT; Metzger, R; Hranjec, T; Rosenberger, LH; Riccio, LM; McLeod, MD; Guidry, CA; Stukenborg, GJ; Swenson, BR; Sawyer, RG ...
Published in: Am J Clin Nutr
November 2014

BACKGROUND: Proper caloric intake goals in critically ill surgical patients are unclear. It is possible that overnutrition can lead to hyperglycemia and an increased risk of infection. OBJECTIVE: This study was conducted to determine whether surgical infection outcomes in the intensive care unit (ICU) could be improved with the use of hypocaloric nutritional support. DESIGN: Eighty-three critically ill patients were randomly allocated to receive either the standard calculated daily caloric requirement of 25-30 kcal · kg(-1) · d(-1) (eucaloric) or 50% of that value (hypocaloric) via enteral tube feeds or parenteral nutrition, with an equal protein allocation in each group (1.5 g · kg(-1) · d(-1)). RESULTS: There were 82 infections in the hypocaloric group and 66 in the eucaloric group, with no significant difference in the mean (± SE) number of infections per patient (2.0 ± 0.6 and 1.6 ± 0.2, respectively; P = 0.50), percentage of patients acquiring infection [70.7% (29 of 41) and 76.2% (32 of 42), respectively; P = 0.57], mean ICU length of stay (16.7 ± 2.7 and 13.5 ± 1.1 d, respectively; P = 0.28), mean hospital length of stay (35.2 ± 4.9 and 31.0 ± 2.5 d, respectively; P = 0.45), mean 0600 glucose concentration (132 ± 2.9 and 135 ± 3.1 mg/dL, respectively; P = 0.63), or number of mortalities [3 (7.3%) and 4 (9.5%), respectively; P = 0.72]. Further analyses revealed no differences when analyzed by sex, admission diagnosis, site of infection, or causative organism. CONCLUSIONS: Among critically ill surgical patients, caloric provision across a wide acceptable range does not appear to be associated with major outcomes, including infectious complications. The optimum target for caloric provision remains elusive.

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Published In

Am J Clin Nutr

DOI

EISSN

1938-3207

Publication Date

November 2014

Volume

100

Issue

5

Start / End Page

1337 / 1343

Location

United States

Related Subject Headings

  • Nutritional Support
  • Nutritional Requirements
  • Nutrition & Dietetics
  • Middle Aged
  • Male
  • Logistic Models
  • Length of Stay
  • Intensive Care Units
  • Humans
  • Female
 

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Charles, E. J., Petroze, R. T., Metzger, R., Hranjec, T., Rosenberger, L. H., Riccio, L. M., … Sawyer, R. G. (2014). Hypocaloric compared with eucaloric nutritional support and its effect on infection rates in a surgical intensive care unit: a randomized controlled trial. Am J Clin Nutr, 100(5), 1337–1343. https://doi.org/10.3945/ajcn.114.088609
Charles, Eric J., Robin T. Petroze, Rosemarie Metzger, Tjasa Hranjec, Laura H. Rosenberger, Lin M. Riccio, Matthew D. McLeod, et al. “Hypocaloric compared with eucaloric nutritional support and its effect on infection rates in a surgical intensive care unit: a randomized controlled trial.Am J Clin Nutr 100, no. 5 (November 2014): 1337–43. https://doi.org/10.3945/ajcn.114.088609.
Charles EJ, Petroze RT, Metzger R, Hranjec T, Rosenberger LH, Riccio LM, et al. Hypocaloric compared with eucaloric nutritional support and its effect on infection rates in a surgical intensive care unit: a randomized controlled trial. Am J Clin Nutr. 2014 Nov;100(5):1337–43.
Charles, Eric J., et al. “Hypocaloric compared with eucaloric nutritional support and its effect on infection rates in a surgical intensive care unit: a randomized controlled trial.Am J Clin Nutr, vol. 100, no. 5, Nov. 2014, pp. 1337–43. Pubmed, doi:10.3945/ajcn.114.088609.
Charles EJ, Petroze RT, Metzger R, Hranjec T, Rosenberger LH, Riccio LM, McLeod MD, Guidry CA, Stukenborg GJ, Swenson BR, Willcutts KF, O’Donnell KB, Sawyer RG. Hypocaloric compared with eucaloric nutritional support and its effect on infection rates in a surgical intensive care unit: a randomized controlled trial. Am J Clin Nutr. 2014 Nov;100(5):1337–1343.
Journal cover image

Published In

Am J Clin Nutr

DOI

EISSN

1938-3207

Publication Date

November 2014

Volume

100

Issue

5

Start / End Page

1337 / 1343

Location

United States

Related Subject Headings

  • Nutritional Support
  • Nutritional Requirements
  • Nutrition & Dietetics
  • Middle Aged
  • Male
  • Logistic Models
  • Length of Stay
  • Intensive Care Units
  • Humans
  • Female