Journal of the Korean Dietetic Association (대한영양사협회학술지)

The Korean Dietetic Association (대한영양사협회)
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The Calorie and Protein Intake of Critically Ill Patients Who Require Continuous Renal Replacement Therapy in the Intensive Care Unit

중환자실에서 지속성 신대체요법을 받은 신부전 환자의 칼로리와 단백질 공급 현황

  • Lee, Ho-Sun (Dept. of Nutrition and Dietetics, Severance Hospital) ;
  • Park, Moo-Suk (Dept. of Internal Medicine, Yonsei University College of Medicine) ;
  • Na, Sung-Won (Dept. of Anesthesiology and Pain Medicine, and Anesthesia and Pain Research Institute, Yonsei University College of Medicine) ;
  • Lee, Jae-Gil (Dept. of Surgery, Yonsei University College of Medicine) ;
  • Yoo, Tae-Hyun (Dept. of Internal Medicine, Yonsei University College of Medicine) ;
  • Koh, Shin-Ok (Dept. of Anesthesiology and Pain Medicine, and Anesthesia and Pain Research Institute, Yonsei University College of Medicine) ;
  • 이호선 (세브란스병원 영양팀) ;
  • 박무석 (연세대학교 의과대학 내과학교실) ;
  • 나성원 (연세대학교 의과대학 마취통증의학교실 및 마취통증의학 연구소) ;
  • 이재길 (연세대학교 의과대학 외과학교실) ;
  • 유태현 (연세대학교 의과대학 내과학교실) ;
  • 고신옥 (연세대학교 의과대학 마취통증의학교실 및 마취통증의학 연구소) ;
  • 중환자실 영양지원팀 (중환자실 영양지원팀)
  • Received : 2009.07.03
  • Accepted : 2009.09.14
  • Published : 2009.11.02
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Abstract

Forty-two percent of the patients with renal failure that requires continuous renal replacement therapy (CRRT) have been reported to have severe malnutrition, and preexisting malnutrition is a statistically significant and independent predictor of negative hospital outcomes. We performed this study to evaluate the appropriateness of the calorie and protein provided for the critically ill patients who require CRRT. One hundred forty-nine patients who received CRRT were enrolled. The demographic data, the length of the ICU stay and the mortality were recorded. The calorie/protein intake and the blood urea nitrogen (BUN), albumin and creatinine levels were used as nutritional parameters. The mean daily calorie intake during CRRT was 16.1${\pm}$7.4 kcal/kg, which was 64% of the recommended intake. Only 10% of the patients received the recommended caloric intake and the ratio of the enteral and parenteral calories was 26%/74%. The mean protein intake was 0.58${\pm}$0.34 g/kg, which was 38% of the recommended intake. The calorie and protein intakes at the termination of CRRT were significantly increased compared to the initial day of treatment, but they stayed under the recommended intake. The BUN, creatinine and albumin levels were significantly increased in the survival group (odds ratio for albumin: 2.73; creatinine: 2.43). A strategy to increase the nutrition provision is needed to improve the nutritional statuses and clinical outcomes of the critically ill patients who require CRRT.

Keywords

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