Impact of cumulative calorie and protein deficit in critically ill patients

This study aims to assess the outcome of cumulative protein and calorie deficit in critically ill patients.
A prospective observational study was conducted in a mixed medical surgical ICU in a tertiary care hospital in India. Patients receiving nutritional support for 2 days were included. Requirement of calorie and protein were fixed as per the ASPEN guidelines. The calorie and protein deficit were calculated daily by the subtraction of the prescribed calorie and protein for each patient. This deficit (<80% of prescribed were given to patients) was then correlated with the outcome and complications.

A total of 768 patients age 61(SD ± 17.67) were analyzed, of which 66.54% were male. 530 (69%) were calorie deficient and 696 (90%) were protein deficient during their whole ICU stay. The correlation coefficient of the ICU length of stay (LOS) was –0.443 and –0.465, and for days on mechanical ventilation for ‘alive’ patients was -0.338 and -0.392 for calorie & protein deficit respectively (p <0.001). Infectious complications were also significantly correlated (-0.346 for calorie deficit,-0.298 for proteins, p <0.001). Mean calorie deficit of the patients discharged alive from the ICU was -2135.62 ± 1918.63 which was less as compared to patients who had expired[-2564.44 ± 2173.45 (p= 0.027)]. This was also seen in the hospital outcome. Mean calorie deficit of patients discharged from the hospital was – 2039.36 ± 1888.82 which was less than the patients who had expired after discharge from the ICU [– 2603.99 ± 2126.53 (p= 0.002].
The cumulative nutrient deficit (calorie and protein) were correlated with increasing number of complications in critically ill patients.

No relevant conflicts of interest declared.