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P037 RISK FACTORS TO RECEIVE LESS THAN 80% OF NUTRITION SUPPORT IN CRITICALLY ILL PATIENTS
44 patient with TPN associated hypertriglyceridemia (62% vs. 22%, p = 0.051; 100% vs. 67%, p = 0.068). Conclusion: TPN associated hypertriglyceridemia increased the morbidity and prolonged hospital stay of patient with TPN. Disclosure of Interest: None declared
P036 USEFULNESS OF INDIRECT CALORIMETRY FOR THE ISCHEMIC STROKE PATIENTS TREATED WITH THERAPEUTIC HYPOTHERMIA H. Iwakawa1 , M. Kurihara1 , T. Jotatsu1 , M. Sasaki1 , T. Sasaki2 , T. Saotome2 , Y. Eguchi2 . 1 Division of Clinical Nutrition, 2 Emergency and I.C.U., Shiga University of Medical Science, Otsu, Japan Rationale: We evaluated metabolic dynamics by indirect calorimetry in the patients with ischemic stroke treated with therapeutic hypothermia. Methods: We studied eight consecutive patients with ischemic stroke (6 women and 2 men, median age 47 years old). We used cervical cooling pads, and patient’s drum temperatures were maintained to 33 34deg; C for 48 hours. Before and after therapeutic hypothermia, we measured resting energy expenditure (REE) and respiratory quotient (RQ) continuously by using an indirect calorimeter AE300S (Minato Co., Japan). We compared REE with basal energy expenditure (BEE) calculated by Harris-Benedict formula. Results: REE was significantly decreased during therapeutic hypothermia, but REE was maintained in BEE level after cooling to drum temperature 34ºC. After rewarming, REE/BEE ratio was markedly increased and returned to 1.420, the basal level. RQ was significantly decreased during hypothermia, and returned basal level after rewarming. There were significant correlations between REE/BEE ratio and drum temperature (r = 0.659, p < 0.005) or between RQ and drum temperature (r = 0.384, p < 0.05). Conclusion: We found a significant fall in REE in the patients receiving therapeutic hypothermia. However, REE was maintained in fundamental physiological function level during cooling. During steady state of hypothermia, a main energy source was fat. Indirect calorimetry is a useful tool for nutritional management for the patients treated with hypothermia. Disclosure of Interest: None declared
P037 RISK FACTORS TO RECEIVE LESS THAN 80% OF NUTRITION SUPPORT IN CRITICALLY ILL PATIENTS ´ guiar2 , A. Taveira Gomes3 . L. Trindade1 , J. Pereira2 , L. A 1 Nutri¸ca ˜o cl´ ınica, Hospital Privado dos Cl´ erigos, 2 Servi¸co de Cuidados Intensivos, 3 Servi¸co de Cirurgia, Hospital S. Jo˜ ao, Porto, Portugal Rationale: Nutritional support (NS) is very important in the management of critically ill patients. Although we know the benefits of NS the amount of prescribed nutrition in intensive care units (ICU) is not always delivered due to several reasons. The goal of this study was to determine the reasons Methods: Prospective analysis of consecutively admitted patients in two mixed ICU: UCIPU (with a nutritionist)
Poster presentations and UCIPG (without a nutritionist). Exclusion criteria were: NS for <2 days, age <16 years and length-of-stay (LOS) <3 days. Patients were followed for the first 7 days of NS. Data collection included: demographic data, NS (route, target volume (TV) and delivered volume), reasons for suspension and reduction of NS. Chi-square, Mann Whitney U, T-test and logistic regression analysis were used in statistical analysis Results: One hundred and two patients (687 nutrition days (ND): enteral (EN) 84.9%, parenteral (PN) 10% and mixed (MN) 3.2%) were studied: mainly male (69.6%) with a mean age 57.9±17.8 and a mean SAPS II score 49.6±14.4. NS was started meanly 34±18.3 hours after ICU admission most times by enteral route (89.2%). TV was achieved in 42.2% of the cases. In 23.6% of the days NS was suspended mainly in UCIPG (28.0% vs. 18.9%; p = 0.006) due to gastrointestinal dysfunction (GI) (46.9%), airway management (6.8%), diagnostic exams (25.3%) and lack of route delivery (8.0%). NS period (OR = 1.30; CI = 1.18 1.43) and UCIPG admission (OR = 1.60; CI = 1.02 2.52) were risk factors to NS suspension in a multivariate logistic regression (MLR) model. In 68.3% of ND >80% of the prescribed volume was delivered more frequently in UCIPU (74.2% vs. 62.6%; p = 0.001). MLR analysis showed that the longer the time of NS the higher the risk of receiving <80% of NS prescribed (OR = 1.56; CI = 1.41 1.72) and the use of PN (OR = 0.14; CI = 0.04 0.47) or MN (OR = 0.10; CI = 0.02 0.40) was associated with a NS delivery >80%. Median ICU LOS was 18.5 days with an ICU mortality of 25.5% Conclusion: In this study, a longer duration of NS and EN were associated to the delivery of <80% of the NS prescribed. We also concluded that admission to an ICU without a nutritionist and a longer duration of NS were risk factors for NS suspension Disclosure of Interest: None declared
P038 THE RELATIONSHIP BETWEEN CIRCULATING CAROTENOID CONCENTRATIONS AND SURVIVAL IN PATIENTS WITH CRITICAL ILLNESS A.T. Vasilaki1 , D.C. McMillan2 , D. Talwar3 , A. Duncan3 , D.S.t.J. O’Reilly3 , J. Kinsella4 . 1 Anaesthesia, Surgery and Clinical Biochemistry, 2 Surgery, University of Glasgow, 3 Clinical Biochemistry, Royal Infirmary, 4 Anaesthesia, Pain and Critical Care Medicine, University of Glasgow, Glasgow, United Kingdom Rationale: There is increasing evidence that suggests systemic inflammatory response associated with acute injury and infection may lower micronutrient concentrations in plasma, independent of tissue status. With reference to antioxidants it has been previously shown that plasma concentrations of carotenoids are extremely low in patients with critical illness (1). The carotenoids, lutein, lycopene, alpha- and beta-carotene have important antioxidant properties with the capability to quench oxygen derived radicals and prevent cellular damage. The aim of this study was to examine whether such low circulating carotenoid concentrations predict outcome in patients with critical-illness.
P036 USEFULNESS OF INDIRECT CALORIMETRY FOR THE ISCHEMIC STROKE PATIENTS TREATED WITH THERAPEUTIC HYPOTHERMIA H. Iwakawa1 , M. Kurihara1 , T. Jotatsu1 , M. Sasaki1 , T. Sasaki2 , T. Saotome2 , Y. Eguchi2 . 1 Division of Clinical Nutrition, 2 Emergency and I.C.U., Shiga University of Medical Science, Otsu, Japan Rationale: We evaluated metabolic dynamics by indirect calorimetry in the patients with ischemic stroke treated with therapeutic hypothermia. Methods: We studied eight consecutive patients with ischemic stroke (6 women and 2 men, median age 47 years old). We used cervical cooling pads, and patient’s drum temperatures were maintained to 33 34deg; C for 48 hours. Before and after therapeutic hypothermia, we measured resting energy expenditure (REE) and respiratory quotient (RQ) continuously by using an indirect calorimeter AE300S (Minato Co., Japan). We compared REE with basal energy expenditure (BEE) calculated by Harris-Benedict formula. Results: REE was significantly decreased during therapeutic hypothermia, but REE was maintained in BEE level after cooling to drum temperature 34ºC. After rewarming, REE/BEE ratio was markedly increased and returned to 1.420, the basal level. RQ was significantly decreased during hypothermia, and returned basal level after rewarming. There were significant correlations between REE/BEE ratio and drum temperature (r = 0.659, p < 0.005) or between RQ and drum temperature (r = 0.384, p < 0.05). Conclusion: We found a significant fall in REE in the patients receiving therapeutic hypothermia. However, REE was maintained in fundamental physiological function level during cooling. During steady state of hypothermia, a main energy source was fat. Indirect calorimetry is a useful tool for nutritional management for the patients treated with hypothermia. Disclosure of Interest: None declared
P037 RISK FACTORS TO RECEIVE LESS THAN 80% OF NUTRITION SUPPORT IN CRITICALLY ILL PATIENTS ´ guiar2 , A. Taveira Gomes3 . L. Trindade1 , J. Pereira2 , L. A 1 Nutri¸ca ˜o cl´ ınica, Hospital Privado dos Cl´ erigos, 2 Servi¸co de Cuidados Intensivos, 3 Servi¸co de Cirurgia, Hospital S. Jo˜ ao, Porto, Portugal Rationale: Nutritional support (NS) is very important in the management of critically ill patients. Although we know the benefits of NS the amount of prescribed nutrition in intensive care units (ICU) is not always delivered due to several reasons. The goal of this study was to determine the reasons Methods: Prospective analysis of consecutively admitted patients in two mixed ICU: UCIPU (with a nutritionist)
Poster presentations and UCIPG (without a nutritionist). Exclusion criteria were: NS for <2 days, age <16 years and length-of-stay (LOS) <3 days. Patients were followed for the first 7 days of NS. Data collection included: demographic data, NS (route, target volume (TV) and delivered volume), reasons for suspension and reduction of NS. Chi-square, Mann Whitney U, T-test and logistic regression analysis were used in statistical analysis Results: One hundred and two patients (687 nutrition days (ND): enteral (EN) 84.9%, parenteral (PN) 10% and mixed (MN) 3.2%) were studied: mainly male (69.6%) with a mean age 57.9±17.8 and a mean SAPS II score 49.6±14.4. NS was started meanly 34±18.3 hours after ICU admission most times by enteral route (89.2%). TV was achieved in 42.2% of the cases. In 23.6% of the days NS was suspended mainly in UCIPG (28.0% vs. 18.9%; p = 0.006) due to gastrointestinal dysfunction (GI) (46.9%), airway management (6.8%), diagnostic exams (25.3%) and lack of route delivery (8.0%). NS period (OR = 1.30; CI = 1.18 1.43) and UCIPG admission (OR = 1.60; CI = 1.02 2.52) were risk factors to NS suspension in a multivariate logistic regression (MLR) model. In 68.3% of ND >80% of the prescribed volume was delivered more frequently in UCIPU (74.2% vs. 62.6%; p = 0.001). MLR analysis showed that the longer the time of NS the higher the risk of receiving <80% of NS prescribed (OR = 1.56; CI = 1.41 1.72) and the use of PN (OR = 0.14; CI = 0.04 0.47) or MN (OR = 0.10; CI = 0.02 0.40) was associated with a NS delivery >80%. Median ICU LOS was 18.5 days with an ICU mortality of 25.5% Conclusion: In this study, a longer duration of NS and EN were associated to the delivery of <80% of the NS prescribed. We also concluded that admission to an ICU without a nutritionist and a longer duration of NS were risk factors for NS suspension Disclosure of Interest: None declared
P038 THE RELATIONSHIP BETWEEN CIRCULATING CAROTENOID CONCENTRATIONS AND SURVIVAL IN PATIENTS WITH CRITICAL ILLNESS A.T. Vasilaki1 , D.C. McMillan2 , D. Talwar3 , A. Duncan3 , D.S.t.J. O’Reilly3 , J. Kinsella4 . 1 Anaesthesia, Surgery and Clinical Biochemistry, 2 Surgery, University of Glasgow, 3 Clinical Biochemistry, Royal Infirmary, 4 Anaesthesia, Pain and Critical Care Medicine, University of Glasgow, Glasgow, United Kingdom Rationale: There is increasing evidence that suggests systemic inflammatory response associated with acute injury and infection may lower micronutrient concentrations in plasma, independent of tissue status. With reference to antioxidants it has been previously shown that plasma concentrations of carotenoids are extremely low in patients with critical illness (1). The carotenoids, lutein, lycopene, alpha- and beta-carotene have important antioxidant properties with the capability to quench oxygen derived radicals and prevent cellular damage. The aim of this study was to examine whether such low circulating carotenoid concentrations predict outcome in patients with critical-illness.