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Nutrients
Volume 12
Issue 10
10.3390/nu12103137
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Article

Optimizing Nitrogen Balance Is Associated with Better Outcomes in Neurocritically Ill Patients

by
Tae Jung Kim
1,2,
Soo-Hyun Park
3,
Hae-Bong Jeong
1,
Eun Jin Ha
2,4,
Won Sang Cho
4,
Hyun-Seung Kang
4,
Jeong Eun Kim
4 and
Sang-Bae Ko
1,2,*
1
Department of Neurology, Seoul National University Hospital, Seoul 03080, Korea
2
Department of Critical Care Medicine, Seoul National University Hospital, Seoul 03080, Korea
3
Department of Neurology, Inha University Hospital, Incheon 22332, Korea
4
Department of Neurosurgery, Seoul National University Hospital, Seoul 03080, Korea
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(10), 3137; https://doi.org/10.3390/nu12103137
Received: 21 August 2020 / Revised: 7 October 2020 / Accepted: 11 October 2020 / Published: 14 October 2020
(This article belongs to the Section Clinical Nutrition)
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Abstract

Marked protein catabolism is common in critically ill patients. We hypothesized that optimal protein supplementation using nitrogen balance might be associated with better outcomes in the neurointensive care unit (NICU) patients. A total of 175 patients admitted to the NICU between July 2017 and December 2018 were included. Nitrogen balance was measured after NICU admission and measurements were repeated in 77 patients. The outcomes were compared according to initial nitrogen balance results and improvement of nitrogen balance on follow-up measurements. A total of 140 (80.0%) patients had a negative nitrogen balance on initial assessments. The negative balance group had more events of in-hospital mortality and poor functional outcome at three months. In follow-up measurement patients, 39 (50.6%) showed an improvement in nitrogen balance. The improvement group had fewer events of in-hospital mortality (p = 0.047) and poor functional outcomes (p = 0.046). Moreover, improvement of nitrogen balance was associated with a lower risk of poor functional outcomes (Odds ratio, 0.247; 95% confidence interval, 0.066–0.925, p = 0.038). This study demonstrated that a significant proportion of patients in the NICU were under protein hypercatabolism. Moreover, an improvement in protein balance was related to improved outcomes in neurocritically ill patients. Further studies are needed to confirm the relationship between protein balance and outcomes. View Full-Text
Keywords: nitrogen balance; protein; catabolism; critical illness; neurointensive care nitrogen balance; protein; catabolism; critical illness; neurointensive care
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MDPI and ACS Style

Kim, T.J.; Park, S.-H.; Jeong, H.-B.; Ha, E.J.; Cho, W.S.; Kang, H.-S.; Kim, J.E.; Ko, S.-B. Optimizing Nitrogen Balance Is Associated with Better Outcomes in Neurocritically Ill Patients. Nutrients 2020, 12, 3137. https://doi.org/10.3390/nu12103137

AMA Style

Kim TJ, Park S-H, Jeong H-B, Ha EJ, Cho WS, Kang H-S, Kim JE, Ko S-B. Optimizing Nitrogen Balance Is Associated with Better Outcomes in Neurocritically Ill Patients. Nutrients. 2020; 12(10):3137. https://doi.org/10.3390/nu12103137

Chicago/Turabian Style

Kim, Tae J., Soo-Hyun Park, Hae-Bong Jeong, Eun J. Ha, Won S. Cho, Hyun-Seung Kang, Jeong E. Kim, and Sang-Bae Ko. 2020. "Optimizing Nitrogen Balance Is Associated with Better Outcomes in Neurocritically Ill Patients" Nutrients 12, no. 10: 3137. https://doi.org/10.3390/nu12103137

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