Summary
This secondary analysis of a multicentre UK intensive care trial found that intermittent feeding produced a flatter urea-to-creatinine ratio trajectory compared with continuous feeding, suggesting mitigation of catabolism in critically ill patients. Notably, neither total protein intake nor serum essential amino acid concentrations were independently correlated with the urea-to-creatinine ratio, suggesting that feeding pattern rather than absolute amino acid dose may influence protein metabolism during critical illness.
UK applicability
Findings are directly applicable to UK intensive care practice, derived from a multicentre UK trial. Results may inform clinical nutrition protocols for managing muscle catabolism in critically ill patients receiving parenteral or enteral support.
Key measures
Serum urea-to-creatinine ratio (mmol/mmol) measured from day 0 to day 10; essential amino acid concentrations; protein intake; trajectory clustering of urea-to-creatinine ratio
Outcomes reported
The study measured serum urea-to-creatinine ratio trajectories over 10 days in critically ill patients randomised to intermittent or continuous feeding, as a marker of muscle catabolism. Metabolic phenotypes were identified through clustering analysis of urea-to-creatinine ratio trajectories, and associations between amino acid concentrations and this ratio were modelled.
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