The response. of serum transthyret1n levels to nutrition support based on measured energy expenditure during mechanical ventilation in the pediatric intensive care unit

Abstract LEARNING OUTCOME : To state how indirect calorimetry can be used to determine energy needed to support anabolisra in critically ill pediatric patients. This is a prospective, randomized study to determine whether anabolism, demonstrated by increasing transthyretin levels, occurs in response to administration of caloric requirements as identified by indirect calorimetry in critically ill children receiving mechanical ventilation in the Pediatric Intensive Care Unit (PICU). At initiation of nutrition support transthyretin was measured and resting energy expenditure (REE) measured using a metabolic cart (CyberMedic Metascope). Subjects were randomly assigned to receive 100, 125, or 150% of REE as non-protein calories. Nutrition support was provided as infant formula, age-appropriate enteral feeding products, parenteral nutrition, or a combination. Protein intake was based on RDA for age. Transthyretin was measured again after 5 days of nutrition support and the average change for each group was compared.Subjects were grouped based on actual intake.