[Evaluation of a high protein diet in critical care patients].
OBJECTIVE
To verify the hypothesis that a high nitrogen intake leads to better nutritional results in critical patients. REFERENCE POPULATION: Patients hospitalized in the critical care unit between 1995 and 1998 with nutritional support for 14 days, excluding patients with liver and/or kidney failure.


METHODS
The calculation of the requirements was made using a computerized program for determining the eliminated nitrogen, depending on the degree of stress. At the end of the second year the formulae for calculating the requirements were changed, thus we had two groups of patients with a different protein intake. The nutritional biochemical parameters are usually analyzed on days 1, 4, and 14, as were the characteristics of the nutrition used during the first and second week of treatment in both periods.


RESULTS
32 patients were included in the first period, and 50 in the second. It was seen that there were no significant differences between them. The characteristics of the administered nutrition showed a greater caloric supply in the first week of the first period (35.14 +/- 4.4 vs. 30.04 +/- 6.1 cal/kg), with there not being any difference in the protein intake (0.26 +/- 0.04 vs. 0.24 +/- 0.09 grams of nitrogen/kg) and a greater protein intake in the second week of the second period (0.34 +/- 0.06 vs. 0.28 +/- 0.04 grams of nitrogen/kg), with there not being any differences in the caloric intake (34.08 +/- 5.6 vs. 34.13 +/- 3.1 cal/kg). The analyzed parameters did not present any significant differences between the periods. The evolution of these was similar for each period, although in the second period the transferrin improved with respect to the first period, and the decrease in the height creatinine index was stopped in the second week. The nitrogen balance could not be improved.


CONCLUSIONS
The increase in the protein intake above certain limits only very slightly improves some of the nutritional biochemical parameters, without improving the nitrogen balance as a result of an increased elimination thereof.
Serón Arbeloa
C
C
Unidad de Medicina Intensiva, Hospital General San Jorge de Huesca, España.
Avellanas Chavala
M
M
Homs Gimeno
C
C
Larraz Vileta
A
A
Laplaza Marín
J
J
Puzo Foncillas
J
J
D000367:Age Factors; D000368:Aged; D001835:Body Weight; D003422:Critical Care; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009751:Nutritional Requirements
D004044:Dietary Proteins
Evaluación de un alto aporte proteico en pacientes críticos.