Nitrogen Balance and Its relation with Energy and Protein Intake in Criticaly Ill Elderly Patients

Abstract

Introduction:Nitrogen balance in criticaly ill patients has the tendency to be negative due to stress response. In the elderly patients, the metabolic changes risk to worsening nitrogen balance. The aim of this study was to determine nitrogen balance and its correlation with energy and protein intake in critically ill elderly patients within 48 hours in ICU.Methods: The method was cross sectional, consecutive sampling on 26 critically ill elderly subjects. Inclusion criteria were patients admitted to ICU, age >60 years old, male/female, whose family/relatives agreed to join this study. Patients who had urine output <0,5 mL/kg/hours were excluded. Data collected were energy and protein intake, urinary urea nitrogen (UUN), and nitrogen balance during 24 hours I and II of admission.Results: The median age was 70 (61 – 85) years old, body mass index was 22. 9 ­+ 2.7 kg/m2, most of the subjects were surgical patients. In 24 hours I and II, the nitrogen balances were -5.2 (-31.2 − -4.1) and -4.5 + 4.6 respectively, energy intakes were not significantly different; 78.8 + 45.0% and 91.1 + 50.2% respectively, and protein intakes were significantly different; 34.1 + 19.3 g/d and 41.2 + 21.3 g/d respectively. There was positive correlation between nitrogen balance and energy intake; r=0.6 and r=0.5, and also between protein intake; r=0.5 and r=0.4, in 24 hours I and II respectively.Conclusion: There were significantly positive correlation between nitrogen balance with energy and protein intake.