This is a single-center, prospective, randomized, comparative, double-blind controlled clinical study intended to establish 1) the optimal method of determining calorie requirements and 2) the optimal amount of protein supply in chronically ventilated patients.
The study will be performed in a chronic ventilation department. Enrolled patients will be randomly allocated to receive calories as dictated by: The Harriss-Benedict formula (Group 1) or Indirect Calorimetry (Group 2) After one week of admission to the hospital department and study enrollment we will review the first results of the study. After seven days of hospitalization and study enrollment patients who have not been weaned from the ventilator, will be divided into three groups. 1. Patients in the first group will receive caloric support calculated by the HARRISS BENEDICT equation and protein dose of 1.1 to 1.5 grams per kilogram weight. 2. Patients in the second group will receive caloric support as measured by indirect calorimetry and will receive protein at 1.1 grams per kilogram weight. 3. Patients in the third group will receive caloric support as measured by indirect calorimetry and will receive protein at a dose of 1.5 grams per kilogram weight. Outcome of treatment results will be performed after one ,four and eight weeks: 1. Length of hospitalization 2. Weaning from Mechanical Ventilation 3. Development and progression of pressure ulcers 4. Infectious diseases incidence 5. Amount of insulin needed for glucose control 6. Length of mechanical ventilation 7. Readmission to Intensive Care Unit 8. Mortality rate
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
60
Four group 1-dose of caloric support will be calculated by Hariss-Benedict Formula measurement of Resting Energy Expenditure(REE).
For group 2- dose of caloric support will be calculated by Indirect Calorimetric measurement of Resting Energy Expenditure(REE)
Patients in the first group(Group 1A) will receive caloric support calculated by the HARRISS BENEDICT equation and protein dose of 1.1 to 1.5 grams per kilogram weight.
Successful weaning from ventilation
Spontaneous breathing
Time frame: At one, four and eight weeks
Length of hospital stay
Length of hospitalization, in days
Time frame: At 8 weeks
Readmission to Intensive Care Unit
Time frame: At four and eight weeks.
Readmission to Intensive Care Unit Mortality
Time frame: At eight weeks
Length of mechanical ventilation
Length of mechanical ventilation in days/hours
Time frame: At one, four and eight weeks
Infectious diseases incidence
Time frame: At one, four and eight weeks
Development and progression of pressure ulcers
Time frame: At one, four and eight weeks
Checked daily insulin intake among different groups of patients
Glucose Control
Time frame: After one, four and eight weeks
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Patients in the second group(Group 2A) will receive caloric support as measured by indirect calorimetry and will receive protein at 1.1 grams per kilogram weight.
Patients in the third group (Group 3A) will receive caloric support as measured by indirect calorimetry and will receive protein at a dose of 1.5 grams per kilogram weight.