Longitudinal analysis of caloric requirements in critically ill trauma patients: a retrospective cohort study.

Magyar, Christian Tibor Josef; Schnüriger, Beat; Köhn, Nastassja; Jakob, Dominik A; Candinas, Daniel; Hänggi, Matthias; Haltmeier, Tobias (2024). Longitudinal analysis of caloric requirements in critically ill trauma patients: a retrospective cohort study. European journal of trauma and emergency surgery, 50(3), pp. 913-923. Springer-Medizin-Verlag 10.1007/s00068-023-02429-z

[img]
Preview
Text
s00068-023-02429-z.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (2MB) | Preview

PURPOSE

Nutrition is of paramount importance in critically ill trauma patients. However, adequate supply is difficult to achieve, as caloric requirements are unknown. This study investigated caloric requirements over time, based on indirect calorimetry, in critically ill trauma patients.

METHODS

Retrospective cohort study at a tertiary trauma center including critically ill trauma patients who underwent indirect calorimetry 2012-2019. Caloric requirements were assessed as resting energy expenditure (REE) during the intensive care unit stay up to 28 days and analyzed in patient-clustered linear regression analysis.

RESULTS

A total of 129 patients were included. Median REE per day was 2376 kcal. The caloric intake did not meet REE at any time with a median daily deficit of 1167 kcal. In univariable analysis, ISS was not significantly associated with REE over time (RC 0.03, p = 0.600). Multivariable analysis revealed a significant REE increase (RC 0.62, p < 0.001) and subsequent decrease (RC - 0.03, p < 0.001) over time. Age < 65 years (RC 2.07, p = 0.018), male sex (RC 4.38, p < 0.001), and BMI ≥ 35 kg/m2 (RC 6.94, p < 0.001) were identified as independent predictors for higher REE over time. Severe head trauma was associated with lower REE over time (RC - 2.10, p = 0.030).

CONCLUSION

In critically ill trauma patients, caloric requirements significantly increased and subsequently decreased over time. Younger age, male sex and higher BMI were identified as independent predictors for higher caloric requirements, whereas severe head trauma was associated with lower caloric requirements over time. These results support the use of IC and will help to adjust nutritional support in critically ill trauma patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care
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 Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine

UniBE Contributor:

Magyar, Christian Tibor Josef, Schnüriger, Beat, Köhn, Olga Gertrud Nastassja, Jakob, Dominik, Candinas, Daniel, Hänggi, Matthias, Haltmeier, Tobias

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1863-9933

Publisher:

Springer-Medizin-Verlag

Language:

English

Submitter:

Pubmed Import

Date Deposited:

15 Feb 2024 10:06

Last Modified:

16 Jul 2024 00:12

Publisher DOI:

10.1007/s00068-023-02429-z

PubMed ID:

38353717

Uncontrolled Keywords:

Calorimetry, Indirect Critical Illness Multiple Trauma Nutritional Support Treatment Outcome

BORIS DOI:

10.48350/192914

URI:

https://boris.unibe.ch/id/eprint/192914

Actions (login required)

Edit item Edit item
Provide Feedback