Article Abstract

Effect of supplementary parenteral nutrition on glucose and lipid metabolisms, risk of infection, and prognosis in critically ill patients with low body weight

Authors: Wen-Bin Yang, Wei Zhang, Jian-Fang Zhang, Tu-Ying Yang, Zhi-Feng Mo

Abstract

Background: While enteral nutrition (EN) is the preferred route of nutrition support, and total EN often fails to meet the nutritional needs of patients. A combination of multiple nutritional strategies can reach nutritional goals earlier and improve clinical outcomes.
Methods: Totally 108 critically ill patients with a body mass index (BMI) of <22 who were admitted to our intensive care unit (ICU) from May 2017 to December 2018 were randomly divided into EN group (EN support alone) and supplementary parenteral nutrition (SPN) group (EN followed by SPN), with 54 patients in each group. The actual nutrient intake and biochemical markers before and after nutritional support as well as the duration of mechanical ventilation, length of stay (LOS) in ICU, LOS in hospital, ICU/hospital mortality, and infection complications were compared between these two groups.
Results: There were no significant differences in albumin, urea nitrogen, alanine aminotransferase, fasting blood glucose, and triglyceride between the EN group and the SPN group before the nutritional support therapy (P>0.05). After the treatment, the albumin level was significantly higher in SPN group than in EN group (P<0.05), although the levels of urea nitrogen, alanine aminotransferase, fasting blood glucose, and triglyceride showed no significant changes in both groups (all P>0.05). The actual calories and protein intakes in the SPN group were significantly higher than those in the control group (both P<0.05). The SPN group had a considerably shorter duration of mechanical ventilation, LOS in ICU, and LOS in hospital and considerably lower incidences of infection complications than the EN group (all P<0.05). The ICU and hospital mortality rates showed no significant difference between these two groups (both P>0.05).
Conclusions: SPN can improve the caloric and protein intakes, shorten the duration of mechanical ventilation, LOS in ICU, and LOS in hospital, and reduce the incidences of infection complications without apparent impact on blood lipid and sugar profiles or liver/kidney functions.