The Impact of indirect calorimetry guided medical feeding protocol on clinical outcomes in mechanically ventilated critically ill patients /

The international guidelines recommend using indirect calorimetry (IC) to measure energy requirements in critically ill patients than the currently used weight-based equations. This single-centre randomised controlled trial aimed to assess the effects of IC-guided nutrition versus the standard nutri...

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Bibliographic Details
Main Author: Saeed, Samiullah (Author)
Format: Thesis
Language:English
Published: Kuantan, Pahang : Kulliyyah of Medicine, International Islamic University Malaysia, 2021
Subjects:
Online Access:http://studentrepo.iium.edu.my/handle/123456789/11100
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100 1 |a Saeed, Samiullah  |9 5262  |e author 
245 1 4 |a The Impact of indirect calorimetry guided medical feeding protocol on clinical outcomes in mechanically ventilated critically ill patients /  |c by Samiullah Saeed 
264 1 |a Kuantan, Pahang :   |b Kulliyyah of Medicine, International Islamic University Malaysia,  |c 2021 
300 |a xvi, 130 leaves :  |b colour illustrations ;  |c 30 cm. 
336 |a text  |2 rdacontent 
337 |a unmediated  |2 rdamedia 
337 |a computer  |2 rdamedia 
338 |a volume  |2 rdacarrier 
338 |a online resource  |2 rdacarrier 
347 |a text file  |b PDF  |2 rdaft 
500 |a Abstracts in English and Arabic. 
500 |a "A thesis submitted in fulfilment of the requirement for the degree of Master in Medical Sciences." --On title page. 
502 |a Thesis (MMDSC)--International Islamic University Malaysia, 2021. 
504 |a Includes bibliographical references (leaves 104-118). 
520 |a The international guidelines recommend using indirect calorimetry (IC) to measure energy requirements in critically ill patients than the currently used weight-based equations. This single-centre randomised controlled trial aimed to assess the effects of IC-guided nutrition versus the standard nutrition care on clinical outcomes in critically ill patients. Sixty mechanically ventilated patients that were expected to stay in an intensive care unit (ICU) for more than three days were randomised into a group in which energy needs were determined by the IC (IC group) and a group prescribed with 25kcal/kg/day reflecting the standard care (SC group). The primary outcome was the ICU length of stay (LOS). Secondary outcomes included the change in quadriceps muscle layer thickness (QMLT, ultrasound) during the first ten days of ICU admission, hospital LOS, duration of mechanical ventilation, ICU mortality and 28-day-in hospital mortality. The mean energy requirement was similar in both groups (1216±222 vs 1304±211, p = 0.124). The IC group received 85.63% of the IC-based energy goal, whereas the SC group received 76.83% of the formula based energy goal (p = 0.002), although the mean energy intakes were similar in both groups. The protein intake goal was better met in the IC group (89.58 %) than in the SC group (77.66 %) (p = 0.007). Both groups had a median of 8.0 days ICU-LOS (p = 0.424). QMLT was decreased progressively in both IC and SC groups by 21.9% vs 25.3% from day 1 to day 10 (p < 0.001), respectively. There were no significant differences observed in the muscle mass changes and other secondary clinical outcomes between the groups. IC-guided nutrition groups received more energy and protein, with higher feeding adequacy than the standard care group. However, there was no difference in term of clinical outcome and muscle layer thickness between both groups. This study is registered with Clinicaltrials.gov, identifier no. NCT04479254.  
650 0 |a Nutrition  |9 6879  |x Evaluation 
650 0 |a Indirect calorimetry  |9 35917 
650 0 |a Quadriceps muscle   |x Measurement  |9 35918 
655 |a Theses, IIUM local 
690 |a Dissertations, Academic  |x Department of Anaesthesiology and Intensive Care  |z IIUM  |9 12507 
700 0 |a Mohammad Basri Mat Nor  |e degree supervisor  |9 12508 
700 0 |a Azrina MD Ralib  |e degree supervisor  |9 12509 
700 0 |a Edre Mohammad Aidid  |e degree supervisor  |9 12510 
710 2 |a International Islamic University Malaysia.  |b Department of Anaesthesiology and Intensive Care  |9 12511 
856 4 |u http://studentrepo.iium.edu.my/handle/123456789/11100 
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