Pulse Brain · Growing Health Evidence Index
Tier 2 — RCT / large cohortPeer-reviewed

Effect of intermittent or continuous feeding and amino acid concentration on urea‐to‐creatinine ratio in critical illness

Luke Flower, Ryan W. Haines, Angela McNelly, Danielle E. Bear, Kiran V.K. Koelfat, Steven W.M. Olde Damink, Nicholas Hart, Hugh Montgomery, John R. Prowle, Zudin Puthucheary

Journal of Parenteral and Enteral Nutrition · 2021

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Summary

This secondary analysis of a multicentre UK intensive care trial examined whether intermittent feeding—which produces peaks in essential amino acid concentration—confers anabolic advantages over continuous feeding in critically ill patients. Intermittent feeding produced a flatter urea-to-creatinine ratio trajectory compared to continuous feeding, suggesting attenuated muscle catabolism, although neither absolute protein intake nor serum EAA concentrations independently correlated with the outcome measure. The findings suggest that feeding pattern timing, rather than total nutrient quantity alone, may influence muscle preservation during critical illness.

Regional applicability

These findings are directly applicable to UK intensive care practice and nutrition protocols. The study was conducted in UK ICUs and provides evidence that could inform clinical guidelines for enteral nutrition support in critically ill patients, though implementation would require consideration of individual patient tolerance and clinical contraindications to intermittent feeding.

Key measures

Serum urea-to-creatinine ratio (mmol/mmol); urea-to-creatinine ratio trajectory; essential amino acid (EAA) concentration; protein intake; k-means clustering of metabolic phenotypes

Outcomes reported

The study measured serum urea-to-creatinine ratio trajectories over 10 days as a marker of muscle wasting in critically ill patients assigned to intermittent or continuous feeding regimens. The primary outcome was the difference in urea-to-creatinine ratio between feeding arms and its correlation with amino acid concentrations.

Theme
Nutrition & health
Subject
Dietary patterns & chronic disease
Study type
Research
Study design
Secondary analysis of a multicentre RCT
Source type
Peer-reviewed study
Status
Published
Geography
United Kingdom
System type
Human clinical
DOI
10.1002/jpen.2258
Catalogue ID
BFmovbmcbr-iiyld7

Topic tags

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