RSS-Feed abonnieren
DOI: 10.1055/s-2004-824912
Effects of enteral nutrition on nutritional serum markers of 161 hospital patients: a preliminary analysis
Rationale: The amount of enteral nutrition (EN) delivered determines its efficacy. Nutritional and inflammatory markers were prospectively assessed according to the level of coverage of the nutritional needs after 5 days of EN.
Method: The administration of EN (1 kcal/ml and 0.4g protein/ml) was increased by 500ml/day to cover nutritional needs: 1.1 x energy expenditure (Harris-Benedict). At baseline (D0) and after 5d of EN (D5), serum samples of C-Reactive Protein (CRP), albumin, transthyretin (TTR) and Insulin Growth Factor-1 (IGF-1) were obtained. At D5, patients were divided according to the energy target achieved (<65% or >65%).
Results: 161 consecutive patients hospitalised in medical or surgical services were enrolled. 130 successfully completed the protocol (age: 64.7±15yr; BMI: 24±6kg/m2). Mean energy needs were 1614±508kcal/d and 5d mean intake was 914±320 kcal/d. At D0, serum parameters were: CRP 110.8±83.7mg/L, albumin 30.6±6.6g/L, TTR 140±60 mg/L, IGF-1 78.2±42.3 ug/L.
Changes in serum parameters (D5-D0)
|
CRPmg/L |
IGF-1ug/L |
TTR mg/L |
Albuming/L |
All patients |
–25.2±83.0* |
20.8±48.1* |
0.02±0.1 ** |
–1.2±4.8* |
≤65% (n=67) |
–14.7±73.9 |
16.8±47.0* |
0.02±0.1 |
–0.7±4.7 |
>65% (n=63) |
–36.3±90.9* |
25.3±49.3* |
0.03±0.1* |
–1.7±4.9 * |
X: mean±SD; paired t-test *p<0.01; ** p=0.01 |
Conclusion: The efficacy of EN is influenced by inflammatory status. Five days of EN improve serum nutritional markers in patients receiving at least 65% of their metabolic needs. The lack of change in the <65% group (except for IGF-1) might be explained by a more persistent inflammation. IGF-1 and TTR are more sensitive parameters than albumin to assess the efficacy of the nutritional support.