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.
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