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Open AccessArticle

Standard vs. Calorie-Dense Immune Nutrition in Haemodynamically Compromised Cardiac Patients: A Prospective Randomized Controlled Pilot Study

1
Department of Anesthesiology and Intensive Care, E. Meshalkin National Medical Research Center, 630055 Novosibirsk, Russia
2
Department of Intensive Care Medicine, University Hospital, RWTH Aachen University, 52074 Aachen, Germany
3
Laboratory Diagnostics Department, E. Meshalkin National Medical Research Center, 630055 Novosibirsk, Russia
*
Author to whom correspondence should be addressed.
Nutrients 2017, 9(11), 1264; https://doi.org/10.3390/nu9111264
Received: 3 October 2017 / Revised: 10 November 2017 / Accepted: 15 November 2017 / Published: 20 November 2017
(This article belongs to the Special Issue Nutritional Approach to Critically Ill Patients)
Background. The aim of study was to test the hypothesis that early enteral nutrition (EN) with calorie-dense and protein rich enteral formula improves enteral energy and protein delivery in critically ill cardiac patients. Methods. Prospective randomized pilot study of 40 ventilated adult patients undergoing elective cardiac surgery with use of cardiopulmonary bypass receiving inotropic support postoperatively. Patients were to receive either standard isocaloric (1000 Kcal/L and 38 g/L protein) early EN (n = 20) or calorie-dense and protein-rich (1300 Kcal/L and 66.7 g/L protein) early EN (n = 20). Results. The mean time to EN initiation was 27 ± 11 h. Early EN with the calorie-dense formula provided significantly more energy and protein enteral delivery on the 2nd, (p < 0.0001), 5th (p = 0.036), and 7th days (p = 0.024), and was associated with higher levels of prealbumin concentration on the 14th day (0.13 ± 0.01 g/L and 0.21 ± 0.1 g/L; p = 0.04) and significantly increased levels of transferrin on the 3rd, 5th, and 7th day (p < 0.05) after surgery. Conclusion. Present findings support hypothesis that early EN using a calorie-dense and protein rich formula leads to better enteral energy and protein delivery and higher levels of short-lived serum proteins. View Full-Text
Keywords: early enteral nutrition; critical care; cardiac surgery; protein-rich formula; energy-dense formula; enteral energy delivery early enteral nutrition; critical care; cardiac surgery; protein-rich formula; energy-dense formula; enteral energy delivery
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Efremov, S.; Lomivorotov, V.; Stoppe, C.; Shilova, A.; Shmyrev, V.; Deryagin, M.; Karaskov, A. Standard vs. Calorie-Dense Immune Nutrition in Haemodynamically Compromised Cardiac Patients: A Prospective Randomized Controlled Pilot Study. Nutrients 2017, 9, 1264.

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