• Jpen Parenter Enter · Jan 2008

    Effect of calorically dense enteral nutrition formulas on outcome in critically ill trauma and surgical patients.

    • Jodie Bryk, Mazen Zenati, Raquel Forsythe, Andrew Peitzman, and Juan B Ochoa.
    • University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
    • Jpen Parenter Enter. 2008 Jan 1;32(1):6-11.

    BackgroundSurgical and trauma patients are traditionally provided with calorically dense dietary formulas to deliver high amounts of nutrients. The benefits of these formulas remain unproven and may be associated with significant side effects and even increased mortality. We studied outcomes on surgical and trauma patients receiving either a calorically dense dietary formula or a normocaloric dietary formula.MethodsA retrospective analysis comparing outcomes in intensive care unit (ICU) surgical and trauma patients receiving either a calorically dense dietary formula or a normocaloric dietary formula was performed at the University of Pittsburgh Medical Center.ResultsOne hundred seventeen patients met study criteria. Surgical and trauma patients were analyzed separately. Despite receiving different calorically dense diets, caloric intake was not significantly different in surgical patients receiving either diet. However, surgical patients receiving a normocaloric formula exhibited decreased length of stay (14.7 +/- 10.1 vs 25.0 +/- 11.3 days; p = .01), ventilator days (14.3 +/- 12.9 vs 21.3 +/- 10.5 days; p = .04), and average daily glucose levels (129.8 +/- 4.1 vs 157.9 +/- 13.6 mg/dL; p =.01), and were more likely to be directly discharged home compared with those receiving a calorically dense dietary formula. Trauma patients receiving a calorically dense dietary formula were on average 17 years younger (p = .01). However, trauma patients receiving a normocaloric formula exhibited decreased length of stay (15.3 +/- 1.6 vs 18.7 +/- 1.6 days; p = .02) and a greater likelihood of direct discharge home.ConclusionsThe data generated suggest that what a patient is fed affects both short- and long-term outcomes. A prospective study should be designed to determine the ideal calories needed in surgical and trauma patients.

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