LB040 - ADEQUACY OF PROTEIN INTAKE AMONG CRITICALLY ILL PATIENTS IN THE MEDICAL INTENSIVE CARE UNIT (MICU) AT THE NATIONAL HOSPITAL OF SRI LANKA

LB040

ADEQUACY OF PROTEIN INTAKE AMONG CRITICALLY ILL PATIENTS IN THE MEDICAL INTENSIVE CARE UNIT (MICU) AT THE NATIONAL HOSPITAL OF SRI LANKA

W. T. Sonali Perera1,*, D. Priyankara1

1National Hospital , Colombo, Sri Lanka

 

Rationale: Protein intake (0.8-1.3g/Kg/d) is essential for critically ill patients, influencing recovery, immune function, and long-term outcomes. The lowest six-month mortality was observed when protein intake increased from <0.8 g/kg/day on days 1–2 to 0.8–1.2 g/kg/day on days 3–5 and above 1.2 g/kg/day after day 5, with timely intervention. This audit assessed protein intake adequacy compared to prescribed daily requirements to improve protein delivery among patients during the early MICU stay.

Methods: Data were collected retrospectively over one month from MICU dietitian records, feeding charts, and nursing documentation for 50 patients during the first week of their ICU stay. Daily Protein delivery was measured refering to food atlases and labels; adequacy was calculated as a percentage of the prescribed intake for each patient. More than 70% was considered adequate protein intake, according to ESPEN guidelines. Causes for inadequate protein delivery were analyzed according to a checklist.

Results: Most patients, n=40 (80%), received inadequate protein intake during the first week of ICU stay. Individual protein delivery varied between 20% and 80% of the prescribed. Protein delivery was lowest during the first two MICU days, often below 30% of the prescribed, improving gradually by D4-D7, although it remained inadequate. The major contributing factor for inadequacy was non-delivering the prescribed blended/oral feed (72%); other factors include insufficient food intake due to fasting procedures (44%), fluid restrictions (32%), and unavailability of Oral Nutritional Supplements (ONS) (42%).

Conclusion: Inadequate protein delivery highlighted the need for targeted interventions and regular communication between MICU staff and the nutrition teams to strengthen early protein delivery.

References:         1. Singer P, Blaser AR, Berger MM, Calder PC, Casaer M, Hiesmayr M, et al. ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit. Clin Nutr. 2023 Sep;42(9):1671–89.

        2. Koekkoek WAC (Kristine), Setten CH (Coralien) van, Olthof LE, Kars JCN (Hans), Zanten ARH van. Timing of PROTein INtake and clinical outcomes of adult critically ill patients on prolonged mechanical VENTilation: The PROTINVENT retrospective study. Clin Nutr. 2019;38(2):883–90.

Disclosure of Interest: None declared