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Abstract: PO1727

Nutritional Intervention in Intensive Care Unit Patients Undergoing CRRT

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Yang, Jihyun, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Kim, Tae-bum, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Min, Hyeon-Jin, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Son, Young-Bin, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Lee, Jonghyun, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Oh, Sewon, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Kim, Myung-Gyu, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Cho, Won-Yong, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Jo, Sang-Kyung, Korea University Anam Hospital, Seoul, Korea (the Republic of)
Background

Providing adequate calories and protein constitutes an important part of critical care, and inadequate nutrition for critically ill patients is associated with poor prognosis. Therefore, increased loss of amino acids, electrolytes, and water-soluble vitamins during continuous renal replacement therapy (CRRT) could be a therapeutic target. We evaluated whether enforcing protein, trace elements and vitamin supply could improve the prognosis of CRRT patients.

Methods

A nutritional intervention (100 mg/day of Thiamine, 25–30 kcal/kg of energy, 1.8 g/kg of protein, and 50–100 mcg/day of microelement with selenium) was conducted in patients subject to CRRT from May 2020 to December 2020. The primary outcomes were 28-day mortality, CRRT day, ICU stay, and ventilator-free day, and the outcomes before and after the intervention were compared.

Results

Total 88 patients were included during the study period and compared with 88 patients in the previous year. The average age was 68.05 years old, 56 (63.5%) patients were male. At day 1 APACHE-II score was 35.45±9.2, SAPS3 88.1±16.8, SOFA 10.4±2.7. There were 9 (10.2%) patients with ECMO, 78 (88.6%) using ventilator. There were 19 (21.6%) pneumonia with ARDS patient, 18 (20.5%) cardiac disease, 9 (10.2%) UTI sepsis, 11 (12.5%) gastrointestinal bleeding and sepsis, 6 (6.8%) cerebral hemorrhage, and others. The main reason for CRRT was hemodynamic instability. Baseline characteristics including APACHE-II score, SAPS 3, and SOFA were not significantly different between the nutritional intervention and the non-intervention patients. Nutritional intervention did not induce significant changes in 28-day mortality (36 versus 37, p = 0.56) and CRRT days (7.3 ± 6.9 versus 6.3 ± 5.2, p = 0.29). However, nutritional intervention showed minimal improvement in ICU stay (22.1 ± 23.9 vs 20.7 ± 22.1, p = 0.05) and ventilator-free days (17.8 ± 22.3 vs 12.4 ± 14.4, p = 0.05).

Conclusion

This study suggests that support for protein, trace elements, and vitamins may have a positive effect in CRRT patients. Therefore, the nutritional requirements of patients with CRRT should be carefully assessed, individualized, and considered as an important axis of CRRT treatment.

Primary outcome
VariablesConventional (2019) n=88Intervention (2020) n=88p-value
28-day mortality, n (%)
Duration of CRRT, day (mean±SD)
Duration of ventilator, day (mean±SD)
Length of stay, day (mean±SD)
ICU stay
Total hospital stay
36 (40.9%)
7.32 ± 6.9
17.84 ± 22.37

22.14 ± 23.9
45.06 ± 40.13
37 (42.0%)
6.34 ± 5.2
12.47 ± 14.43

20.74 ± 22.18
41.3 ± 46.91
0.56
0.29
0.05

0.05
0.57