O070 - IMPACT ON ICU PATIENTS OF NEW ENTERAL NUTRITION FORMULA DESIGNED TO MAINTAIN AUTOPHAGY THAT IS LOW IN CARBOHYDRATES AND LEUCINE AND HIGH IN LIPIDS

O070

IMPACT ON ICU PATIENTS OF NEW ENTERAL NUTRITION FORMULA DESIGNED TO MAINTAIN AUTOPHAGY THAT IS LOW IN CARBOHYDRATES AND LEUCINE AND HIGH IN LIPIDS

S. Maruyama^1,*, D. Wada¹, J. Shimazaki¹, T. Yoshihara¹, F. Saito¹, K. Yoshiya¹, T. Kagawa², R. Akiyama², I. Yamaoka², Y. Nakamori¹, Y. Kuwagata³

¹Department of Emergency and Critical Care Medicine, Kansai Medical University Medical Center, Osaka, ²Medical Foods Research Institute, Otsuka Pharmaceutical Factory, Inc., Tokushima, ³Department of Emergency and Critical Care Medicine, Kansai Medical University Hospital, Osaka, Japan

Rationale: Severe hypophosphatemia may lead to death after feeding initiation in ICU patients. We developed and launched an enteral nutrition (EN) formula (low glucose, low leucine, high fat) that is less likely to cause hypophosphatemia, which would theoretically lead to activation of autophagy and ketogenesis via inhibition of mTOR.

Methods: A single-centre retrospective cohort study comparing the clinical outcomes with the new and standard EN formulas was conducted in Japan. Patients admitted to the ICU for ≥10 days who received invasive mechanical ventilation for ≥3 days were eligible for inclusion. Patients were divided into the new EN and standard EN groups. The primary outcome was in-hospital death. Secondary outcomes included the dose of electrolytes containing phosphorus and insulin dose. After propensity score matching for background factors, multivariable logistic regression analysis adjusted for clinically important variables was conducted to evaluate clinical outcomes.

Results: The 633 eligible patients were divided into the new EN (n=206) and standard EN (n=427) groups. After propensity score matching, 192 cases were selected in each group. In the new EN group, the amounts of insulin, potassium, phosphate, and magnesium administered were significantly reduced. In-hospital mortality (new EN vs. standard EN: 18 [9.4%] vs. 38 [20%], p=0.006), and 60-day mortality (16 [8.3%] vs. 31 [16%], p=0.029) were significantly lower in the new EN group. A logistic regression analysis showed that the new EN formulation was associated with reduced in-hospital mortality (OR: 0.37, 95% CI: 0.19–0.74, p=0.005).

Conclusion: This new nutrition formula could play an important role in improving mortality among mechanically ventilated ICU patients.

Disclosure of Interest: S. Maruyama: None declared, D. Wada: None declared, J. Shimazaki: None declared, T. Yoshihara: None declared, F. Saito: None declared, K. Yoshiya: None declared, T. Kagawa: None declared, R. Akiyama: None declared, I. Yamaoka: None declared, Y. Nakamori Speakers Bureau of: €10,000, Y. Kuwagata: None declared