Factors affecting the caloric and protein intake over time in critically ill trauma patients.

Haltmeier, Tobias; Inaba, Kenji; Schnüriger, Beat; Siboni, Stefano; Benjamin, Elizabeth; Lam, Lydia; Clark, Damon; Demetriades, Demetrios (2018). Factors affecting the caloric and protein intake over time in critically ill trauma patients. Journal of surgical research, 226, pp. 64-71. Elsevier 10.1016/j.jss.2018.01.022

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BACKGROUND Major trauma leads to increased nutritional requirements. However, little is known about the actual amount of calories and protein administered and the factors affecting the intake over time in critically ill trauma patients. METHODS Prospective study including 100 trauma patients admitted to the Los Angeles County + University of Southern California Medical Center intensive care unit between March 2014 and October 2014. Inclusion criteria were age > 16 y, surgery at admission, and no oral nutrition. The caloric and protein intake was recorded, and requirements were calculated daily for 28 d. The nutritional intake and the impact of clinical factors on the intake over time were assessed using mixed model analysis. RESULTS The caloric and protein intake significantly increased over time, but the median intake did not meet the median calculated requirements at any time. Multivariable analysis revealed a smaller increase of the nutritional intake over time in patients with an injury severity score > 45, whereas penetrating injury and laparotomy were associated with a higher increase of the intake. Body mass index scores ≥ 30 kg/m, traumatic brain injury, and gastrointestinal tract injuries were associated with a smaller increase of the caloric intake over time. CONCLUSIONS The median nutritional intake did not meet the median calculated requirements over time. A smaller increase of the nutritional intake over time was found in patients with a higher injury burden, whereas penetrating injury and laparotomy were associated with a higher increase of the intake. Higher body mass index scores, traumatic brain injury, and gastrointestinal tract injuries were associated with a smaller increase of the caloric intake over time. These clinical factors can help to adjust the nutritional support in critically ill trauma patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Haltmeier, Tobias and Schnüriger, Beat

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1095-8673

Publisher:

Elsevier

Language:

English

Submitter:

Lilian Karin Smith-Wirth

Date Deposited:

10 Apr 2019 15:14

Last Modified:

10 Apr 2019 15:14

Publisher DOI:

10.1016/j.jss.2018.01.022

PubMed ID:

29661290

Uncontrolled Keywords:

Caloric requirements Critical illness Multiple trauma Nutritional support Prospective study Protein requirements

BORIS DOI:

10.7892/boris.125794

URI:

https://boris.unibe.ch/id/eprint/125794

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