Association between energy adequacy and clinical outcomes in septic intensive care unit patients stratified by modified Nutrition Risk in the Critically Ill score.

BACKGROUND

Although malnutrition is common among critically ill patients with sepsis, it is unclear whether early nutritional supplementation is beneficial. We investigated the effects of early calorie and protein delivery in critically ill patients with sepsis.

METHODS

Adult patients with sepsis who required mechanical ventilation in a surgical intensive care unit (ICU) between January 2021 and December 2022 were enrolled. Nutritional risk in these patients was evaluated using the modified Nutrition Risk in the Critically ill (m-NUTRIC) score. Participants were divided into two groups based on whether they received <50% or ≥50% of their estimated calorie needs within the first 5 days of their ICU stay. The primary outcome was 28-day ICU mortality.

RESULTS

Among the 258 participants (195 men and 63 women; mean age, 64.8 ± 13.7 years), within the first 5 days of their ICU stay, 63.2% and 36.8% of the patients received <50% and ≥50% of their estimated calorie needs, respectively. The 28-day ICU mortality rate did not differ significantly between the two groups. Multivariate logistic regression revealed that the use of continuous renal replacement therapy (odds ratio [OR] = 4.07, 95% CI, 1.10-15.09; p = 0.036) and the duration of mechanical ventilation (OR = 1.05, 95% CI, 1.01-1.10; p = 0.020) were independent predictors of 28-day ICU mortality. Providing early nutritional support of ≤50% of the estimated calorie needs did not affect 28-day ICU mortality in these patients ( p = 0.229).

CONCLUSION

Achieving at least 50% of the estimated calorie needs within the first 5 days of ICU stay did not improve 28-day ICU survival in this cohort of critically ill patients with sepsis. Further investigations are needed to elucidate whether early nutritional interventions are beneficial for this population.