• Saúl Rugeles, Luis Gabriel Villarraga-Angulo, Aníbal Ariza-Gutiérrez, Santiago Chaverra-Kornerup, Pieralessandro Lasalvia, and Diego Rosselli.
• Surgery Department, Pontificia Universidad Javeriana, Medical School, Hospital Universitario San Ignacio, Bogota, Colombia. Electronic address: saul.rugeles@gmail.com.
• J Crit Care. 2016 Oct 1; 35: 110-4.

PurposeAppropriate caloric intake in critically ill patients receiving enteral nutrition is controversial. This study evaluates the impact of different caloric regimens on severity of organ failure measured with Sequential Organ Failure Assessment (SOFA).Materials And MethodsWe conducted a randomized prospective controlled trial. Study population included adult intensive care unit (ICU) patients expected to require enteral nutrition for more than 96 hours. Goals in the intervention group were hypocaloric (15 kcal/kg per day) enteral nutrition compared to normocaloric (25 kcal/kg per day) enteral nutrition, both with hyperproteic intake (1.7 g of protein/kg per day). Primary end point was change in SOFA score (ΔSOFA) from baseline at 48 hours. Secondary end points were ΔSOFA at 96 hours, insulin requirements, hyperglycemia or hypoglycemic episodes, length of ICU stay, days on ventilator, and 28-day mortality.ResultsAfter screening 443 patients, 120 patients were analyzed. There were no differences between groups in baseline characteristics. We did not find a statistically significant difference in ΔSOFA at 48 hours. Patients in the hypocaloric group showed lower average daily insulin requirements and percentage of patients requiring any insulin.ConclusionsHyperproteic, hypocaloric nutrition did not show different outcomes compared to normocaloric nutrition, except lower insulin requirements. Hypocaloric nutrition could provide a more physiologic approach with lower need for care and metabolic impact.Copyright © 2016 Elsevier Inc. All rights reserved.

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