Meeting Protein Targets in Critically Ill Patients

Study Overview
=================
Brief Summary
-----------------
This is a retrospective study of protein and energy intake in enterally fed critically ill adult patients before and after the introduction of a very high protein enteral nutrition formula in a single center medical/surgical ICU.

Official Title
-----------------
Meeting Protein Targets in Critically Ill Patients: A Retrospective Analysis

Conditions
-----------------
Critical Illness, Dietary Modification

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Adult patients ≥ 18 years of age, mechanically ventilated Received enteral nutrition for a minimum of five days during the first week of ICU admission Exclusion Criteria: Received parenteral nutrition during first week of ICU admission Acute renal failure not dialyzed Hepatic encephalopathy grade 3 or 4 Intentional underfeeding/trophic feeding - including refeeding syndrome

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Pre-very high protein enteral nutrition<br>20 enterally fed critically ill adult patients prior to the introduction of a very high protein enteral nutrition formula [2015]. | |
| Post-very high protein enteral nutrition<br>20 enterally fed critically ill adult patients post the introduction of a very high protein enteral nutrition formula [2016]. | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Daily total protein intake | Daily total protein intake and percent prescribed protein needs met during first week of ICU admission. | Daily up to 7 days of ICU stay | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Daily caloric intake - Total Calories | Total calories aggregate from all sources | Daily up to 7 days of ICU stay | 
| Daily caloric intake - kcal/kg | Total volume consumed and weight will be used to measure kcal/kg | Daily up to 7 days of ICU stay | 
| Daily caloric intake from enteral nutrition | Daily caloric intake from enteral nutrition, and medications (i.e. Propofol) | Daily up to 7 days of ICU stay | 
| Percentage of prescribed calorie needs met | Percentage of prescribed calorie needs met | Daily up to 7 days of ICU stay | 
| Feeding interruptions | Feeding interruptions; and reason for interruption, if recorded in electronic medical record/nursing flow sheets | Daily up to 7 days of ICU stay | 
| Use of inotropes/vasopressors (highest daily dose prescribed) | Use of inotropes/vasopressors will be documented as a Yes/No. | Daily up to 7 days of ICU stay | 
| Feeding tolerance | Feeding tolerance as recorded by clinicians in electronic medical record/nursing flow sheets [gastrointestinal side effects observed and documented: vomiting, elevated Gastric Residual Volumes (>200 mL), aspiration, pneumonia, diarrhea (Bristol stool chart definition and ≥ 3 liquid stools/day)] | Daily up to 7 days of ICU stay |