2023/12/31 by Alexandria Page, Anne Langan, Yize I. Wan +4
paper · doi:10.1002/jpen.2586
Abstract Background Patients experiencing persistent critical illness have poor short‐term and long‐term outcomes and consume disproportionate amounts of health care resources. Nutrition optimization may improve outcomes, though few data exist on resting energy expenditure and nutrition requirements. We hypothesized that increased energy surplus per day is associated with increased intensive care unit (ICU) length of stay (LoS) in critically ill patients. Methods Patients from a single ICU at Royal London Hospital were included in this retrospective cohort study. Exposure: energy surplus measured by serial indirect calorimetry (IC) and nutrition intake. Inclusion criteria: mechanical ventilation of ≥3 days and expected to remain ventilated. Primary outcome: ICU LoS. Results Across 30 patients (median LoS 21 days), increased ICU LoS was associated with actual daily energy intake surplus to resting energy expenditure (REE) ( R 2 0.16; P P P = 0.011); however, they had a median LoS of 44 days (IQR 26–58) vs 10 days (IQR 7–24), respectively ( P P = 0.021). Conclusion Overfeeding represents an easily modifiable factor to improve outcomes in patients experiencing persistent critical illness, for which IC may be useful.