Adequate nutritional support is an essential element for achieving favourable outcomes in critically ill patients. Therefore, an accurate determination of patients' energy needs is required to optimize nutritional support and reduce the harmful effects of under- and over-feeding. Currently, indirect calorimetry is considered as a gold standard for measuring energy expenditure during critical illness. This randomized study aims to investigate the impact of indirect calorimetry guided nutrition therapy on clinical outcomes such as ICU. Mortality, hospital mortality, duration of mechanical ventilation, length of I.C.U./hospital stay and mascle wasting. The investigators hypothesis that nutrition therapy guided by IC will improve clinical outcomes in severely ill patients
This is a single-blind randomized control study. Eligible participants are randomly assigned within 24 hrs of ICU. admission in two groups * Intervention group: The calorie needs will be determined by indirect calorimetry. * Control group: a routine standard weight-based equation (20-25kcal/kg ideal body weight/day) will be used to estimate the energy requirements of critically ill patients. Daily energy and protein data will be recorded for a maximum of 12 evaluable days (nutritional days) or until death or discharge from ICU.while outcome data will be collected for a maximum of 28 days.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
60
Enteral nutrition feeding formula is used in powder form and will be reconstituted by attending nurses, Continuous feeding is commonly used which will be prescribed by the attending clinicians, Energy and protein intake from EN will be estimated by multiplying the volume of feed given to energy (kcal) and protein (g) in 1 ml of standard dilution, and for Standard PN product, energy and protein intake will also be calculated based on the volume infused.
IIUM- Medical Center
Kuantan, Pahang, Malaysia
ICU mortality
Rate of mortality from all causes before or at day 28 in the ICU during the same ICU admission
Time frame: 28 Days
Length of ICU stay
will be measured as the number of calendar days between admission and discharge from ICU.or until 28 days
Time frame: 28 Days
Length of mechanical ventilation
will be measured as the calendar days between start and end of mechanical ventilation until 28 days
Time frame: 28Days
Length hospital stay
will be calculated using the admission date and expiration or discharge date from hospital until 28 days
Time frame: 28 Days
Hospital mortality
Rate of mortality from all causes (death in ICU or in ward) before or at day 28 during the same hospital admission.
Time frame: 28Days
Muscle wasting
define as differences between the serial ultrasound measurement of quadriceps femoris muscle layer thickness (vastus intermedius and rectus femoris) over the first 10 days(on day 1,3,5,7 and 10 ) of ICU Admission.
Time frame: First 10 days of ICU admission
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