Comparison of the effect of three different protein content enteral diets on serum levels of proteins, nitrogen balance and energy expenditure in critically ill infants: study protocol for a randomized controlled trial

• Published in: Trials
• Main Authors: Reyes Fernández Montes, Javier Urbano Villaescusa, Ángel Carrillo Álvarez, Ana Vivanco Allende, Solana García, María José, Corsino Rey Galán, Jesús López-Herce Cid
• Format: Web Resource
• Language: English
• Published: Durham Research Square 11.10.2019
• Subjects: Attitudes; Clinical trials; Infants; Nitrogen; Nutrition; Patients; Proteins
• DOI: 10.21203/rs.2.9921/v2

Background Nutritional support is essential in the care of critically ill children, since malnutrition in this population is associated to increased morbidity and mortality. Injury in patients admitted to pediatric intensive care units (PICU) results in a catabolic state, with augmented protein breakdown, leading to a negative protein balance. Current recommendations about protein prescription in PICU are fundamentally based on expert opinions, with a minimum threshold of 1.5 g/kg/day of protein, although protein needs could be higher in certain subgroups of patients. The main objective of the present study is to examine if the administration of a protein-enriched infant formula increases the serum levels of total proteins, albumin, prealbumin, transferrin, retinol, and improves nitrogen balance; and to analyze the effect of the high-protein diet on energy expenditure. A secondary objective is to register possible secondary effects of the protein-enriched diet. Methods a multicenter prospective randomized controlled trial (RCT) will be performed in three hospitals. Patients meeting inclusion criteria will be randomly allocated to one of three enteral feeding formula with different protein content. Blood and urine test, nitrogen balance assessment and energy expenditure testing by indirect calorimetry will be performed at the beginning of nutrition regimen and at 24 hours, 72 hours and 5-7 days after initiation. The sample size for this trial is estimated as 90 participants, with approximately 30 participants in each group. The data analysis will be by intention to treat. Discussion this RCT will provide new data about the amount of protein needed to improve levels of serum protein and nitrogen balance, surrogate of protein balance, in critically ill infants receiving enteral nutrition.