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.
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