Summary
This secondary analysis of a UK intensive care trial examined whether intermittent feeding regimens attenuate muscle protein catabolism compared with continuous feeding. Patients receiving intermittent feeding demonstrated a significantly flatter urea-to-creatinine ratio trajectory over 10 days, suggesting reduced muscle wasting despite no independent correlation between absolute amino acid or protein concentrations and the catabolic marker. The findings suggest that the temporal pattern of nutrient delivery, rather than absolute nutrient dose, may influence muscle protein metabolism in critical illness.
UK applicability
These findings are directly applicable to UK critical care practice, as the study was conducted in UK intensive care units. The results may inform future guidelines on enteral nutrition delivery protocols for mechanically ventilated patients, though clinical implementation would require consideration of patient tolerance, feeding access, and broader metabolic outcomes beyond the urea-to-creatinine ratio.
Key measures
Serum urea-to-creatinine ratio (millimole per millimole) from day 0 to day 10; essential amino acid concentrations; 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 catabolism in critically ill patients assigned to intermittent or continuous enteral feeding regimens. Secondary analysis examined associations between amino acid concentrations and urea-to-creatinine ratio to explore potential anabolic advantages of feeding pattern.
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