Nitrogen balance in mechanically ventilated obese patients

• Autor(a) principal: Stocker PÉRSICO, Raquel
• Data de Publicação: 2022
• Outros Autores: Corrêa SOUZA, Gabriela, Stuani FRANZOSI, Oellen, de Almeida Rubin ROVATI, Bibiana, de Albuquerque SANTOS, Zilda Elisabeth
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Revista de Nutrição
• Texto Completo: https://periodicos.puc-campinas.edu.br/nutricao/article/view/6116
• topic: Critical care; Enteral nutrition; Intensive care units; Mechanical ventilation; Nutrition therapy; Obesity

Objective This study aimed to evaluate if the protein intake recommendations for obese critically ill requiring mechanical ventilation are sufficient to promote a positive or neutral nitrogen balance.MethodsCross-sectional study that included 25 obese, ≥18 years old, undergoing mechanical ventilation and who were target to receive high-protein enteral nutrition therapy (2.0-2.5g/kg ideal body weight). Clinical, nutritional and biochemical variables were analyzed. Nitrogen balance was performed when patient was receiving full enteral nutrition therapy and was classified: positive when intake was greater than excretion; negative when excretion was greater than intake; neutral when both were equal. ResultsThe characteristics of patients evaluated were 64.1±9.4 years old, clinical treatment 88%, body mass index 36.5±5.1kg/m², nitrogen balance 0.3g/day (-5.3 to 4.8g/day), protein intake 2.1g/day (2.0-2.3g/kg) ideal body weight. Of individuals analyzed, 52% showed positive or neutral nitrogen balance with median of 4.23g/day 2.41 to 6.40g/day) in comparison to negative group with median of -5.27g/day (-10.38 to -3.86g/day). Adults had higher ratio of negative nitrogen balance (57.1%) than elderly (44.4%), with protein intake of 2.0 versus 2.1g/day, respectively. No correlation was found between nitrogen balance and variables assessed.ConclusionHigh-protein enteral nutrition therapy contributed to positive or neutral nitrogen balance for approximately half of obese ventilated individuals. With similar protein intake, elderly showed a higher proportion of positive or neutral nitrogen balance. Nitrogen balance can be influenced by various factors, so further studies are required to identify different protein needs in obese critically.