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 UK intensive care trial examined whether intermittent feeding—which produces peaks in essential amino acid concentrations—confers anabolic advantages over continuous feeding in critically ill patients. Intermittent feeding was associated with a flatter, less steep urea-to-creatinine ratio trajectory, suggesting mitigation of muscle catabolism, though total protein intake and serum EAA concentrations alone did not correlate with this protective effect. The findings suggest timing of nutrient delivery may be more metabolically relevant than absolute quantities in critical care nutrition.

UK applicability

These findings are directly applicable to UK critical care practice, as the trial was conducted in UK intensive care units. The results may inform clinical guidelines on enteral nutrition timing and regimen selection in critically ill patients within the UK NHS.

Key measures

Serum urea-to-creatinine ratio (mmol/mmol) from day 0 to day 10; essential amino acid (EAA) serum concentrations; total protein intake; k-means clustering of urea-to-creatinine ratio trajectories

Outcomes reported

The study measured serum urea-to-creatinine ratio trajectories over 10 days as a marker of muscle wasting, and examined associations between feeding regimen (intermittent vs continuous), amino acid concentrations, and protein intake with catabolism markers.

Theme
Nutrition & health
Subject
Micronutrients & dietary adequacy
Study type
Research
Study design
Secondary analysis of a randomised controlled trial (multicenter UK intensive care)
Source type
Peer-reviewed study
Status
Published
Geography
United Kingdom
System type
Human clinical
DOI
10.1002/jpen.2258
Catalogue ID
BFmovi1x8l-3awmzh

Topic tags

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