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BACKGROUND: Caloric insufficiency during the first week of intensive care unit (ICU) stay was reported to be associated with increased nosocomial infection rates. This study aimed to identify the association between energy and protein deficit with Hospital- Acquired Infection (HAI) among critically ill patients.
METHOD: A prospective, observational study was conducted on adult critically ill patient receiving nutritional support within 48 hours of ICU admission in University Malaya Medical Centre. Daily energy and protein balance was recorded for 14 days. Daily energy and protein balance were calculated by using deducting prescribed (energy /protein) from intake. All microbiological specimen were considered in determining infection incidence in ICU.
RESULTS: Ninety patients were included in this study. Mean energy and protein balance was -184.62 kcal/day and -13.66g/day. Cumulative energy and protein balance for 14 days was -1744.61 kcal/day and -97.69 g/day. Thirty-nine patients had infections in ICU with 54% of them had ventilator-acquired Pneumonia. There was no association between energy balance and protein balance infection(r= 1.000, p=0.127 vs. r= 0.101, p=0.343). Energy deficit of critically ill patients who had infections were higher (209 kcal/day) compared to patients who had no infection (166 kcal/day) but the difference was not significant (p=0.574). There was no association between enteral and parenteral nutrition, (r=0.105, p=1.000) vs. r=0.003, p=1.000) with infection. However, we found positive correlation between NUTRIC score and energy balance (r=1.000, p= 0.017).
CONCLUSIONS: There was no association between energy and protein deficit with HAIs.
Keywords- Energy and protein balance, Energy deficit, Protein deficit, Hospital-Acquired Infection