Abstract

FREITAS, Renata Germano Borges de Oliveira Nascimento; NEGRAO NOGUEIRA, Roberto José  and  HESSEL, Gabriel. Protein needs of critically ill patients receiving parenteral nutrition. Nutr. Hosp. [online]. 2015, vol.32, n.1, pp.250-255. ISSN 1699-5198.  https://dx.doi.org/10.3305/nh.2015.32.1.8913.

Background: assess whether the current protein intake recommendations may improve the biochemical parameters of critical patients receiving parenteral nutrition. Methods: longitudinal study with three evaluations made (during the first 72 hours, on the 7^th and the 14^th days of PN). The following tests were applied: albumin, C-reactive protein, prealbumin, total cholesterol, HDL, triglycerides, lymphocytes, and glutathione peroxidase. The severity was determined by SOFA. The statistical analysis included the Spearman and Mann-Whitney tests, as well as ANOVA (analysis of variance). Results: among the 53 patients evaluated, 20 (37.74%) died. The mean calorie was 24.68 ± 9.78 kcal/kg (beginning of PN), 26.49 ± 8.89 kcal/kg (3^rd to 7^th days of PN), and 30.9 ± 12.19 kcal/kg (7^th to 14^th days of PN). The mean protein was 1.19 ± 0.44 g/kcal/kg (first 72 hours of PN), 1.29 ± 0.44 g/kcal/kg (3^rd to 7^th days of PN) and 1.49 ± 0.69 g/kcal/kg (7^th to 14^th days of PN). Prealbumin, albumin, total cholesterol and HDL were below the reference values, while the CRP levels were high. Throughout the three evaluation times, there was no a significant improvement on the levels of laboratory examinations. A strong and negative correlation was found between SOFA and prealbumin (r = -0.64, p = 0.05). Conclusions: the protein offer, according to the traditional recommendations, was not enough to improve the biochemical parameters of critical patients undergoing parenteral nutrition.

Keywords : Parenteral nutrition; Intensive care unit; Protein.

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