Hypocaloric Nutrition in Critically Ill Patients (RuRaL)

The aim of this study is to compare two nutritional regimes in critically ill patients. Patients will be randomized to standard care (25 kcal per kg) or to hypocaloric nutrition (15 kcal per kg). The main outcome will be the SOFA (sequential organ failure assessment) score. The hypothesis is that hypocaloric hyperproteic diet decreases the incidence of organic failure in these patients.

The research site will be the intensive care unit (ICU) of Hospital Universitario San Ignacio; eligible patients will >18 years of age with a presumed fasting period of at least 96 hours, with no contraindications for enteral nutrition. Patients with parenteral nutrition, pregnancy, diabetes, liver failure, renal failure, transplant protocol, or admitted from another hospital will be excluded. In all patients, the following information will be collected daily: enteral formula in ml, carbohydrate intake, insulin required (in IU), presence of hyper or hypoglicemia, presence of infections, among others.

The SOFA score will be assessed every two days until discharge from ICU.

• Dietary Supplement: Hypocaloric hyperproteic nutrition
  15 kcal per kg of body weight and 1.7 grams of protein per kg.
  Other Name: Hypocaloric hyperproteic
• Dietary Supplement: Standard care
  25 kcal per kg of body weight
  Other Name: Isocaloric

• Active Comparator: Standard care
  Patients will receive normal nutritional regime of around 25 kcal per kg.
  Intervention: Dietary Supplement: Standard care
• Experimental: Hypocaloric hyperproteic nutrition
  15 kcal per kg of body weight and 1.7 grams of protein per kg
  Intervention: Dietary Supplement: Hypocaloric hyperproteic nutrition

Inclusion Criteria:

• >18 years
• estimated fasting period of at least 96 hours

Exclusion Criteria:

• parenteral nutrition
• pregnancy
• diabetes
• liver or renal failure
• transplantation
• admitted from another hospital