Intravenous Dextrose Calories in Critically Ill Patients Requiring Vasopressor Therapy

Abstract

Objective: The hidden calories from non-nutritional sources should be considered when prescribing an energy target in intensive care unit (ICU). We aim to determine the calories acquired from intravenous dextrose in patients who required and did not require vasopressor therapy. Materials and Methods: A retrospective study was conducted in a medical ICU. Administered intravenous dextrose grams were recorded for 7 days since the initiation of nutritional support. Daily and average intravenous dextrose calories were compared between vasopressor and non-vasopressor groups. Linear mixed model was used to assess the effect of the conditions requiring vasopressor therapy on intravenous dextrose calories. Results: There were 93 and 129 patients in the vasopressor and non-vasopressor groups. On the first day of nutritional support, intravenous dextrose calories were 134 (interquartile [IQR] 60.4 to 246.7) and 73.6 (IQR 27.9 to 134.8) kcal/day for vasopressor and non-vasopressor groups respectively (p<0.001). Intravenous dextrose calories decreased over 7 days of nutritional support. The average of intravenous dextrose calories in the vasopressor group was higher than the non-vasopressor group (101.7 [IQR 47.8 to 160.3] vs. 56.3 [IQR 19.3 to 125.1] kcal/day, p=0.002). A multivariable linear mixed model showed that the conditions requiring vasopressor led to a significantly increase of intravenous dextrose calories by 40.1 kcal/day (95% CI 7.2 to 73.1). Conclusion: The calories from intravenous dextrose in critically ill patients with vasopressor therapy was higher than that of patients who did not require vasopressor. The conditions requiring vasopressor therapy led to an increase of intravenous dextrose calories by 40 kcal/day. Keywords: Dextrose; Vasopressor; Energy; Calorie; Critically ill