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Critically ill infants benefit from early administration of protein and energy-enriched formula: a randomized

Dick A van Waardenburg1, Carlijn T de Betue, Johannes B van Goudoever

  • 1Department of Pediatrics, Maastricht University and Medical Center, P Debeyelaan 25, Maastricht, The Netherlands. d.vanwaardenburg@mumc.n

Clinical Nutrition (Edinburgh, Scotland)
|April 10, 2009
PubMed

Insights

A protein and energy-enriched infant formula improved nutrient intake and nitrogen balance in critically ill infants with respiratory failure. This enhanced nutritional support was well-tolerated and beneficial for recovery.

Area of Science:

  • Pediatric critical care nutrition
  • Infant respiratory failure management
  • Metabolic balance studies in infants

Background:

  • Nutritional support is crucial for critically ill infants but often hindered by feeding challenges.
  • Protein and energy-enriched formulas may overcome these barriers, promoting anabolism.
  • Respiratory syncytial virus (RSV)-bronchiolitis is a common cause of respiratory failure in infants.

Purpose of the Study:

  • To evaluate the efficacy of a protein and energy-enriched formula compared to a standard formula in critically ill infants.
  • To assess nutrient delivery, energy and nitrogen balance, and plasma amino acid concentrations.
  • To determine the tolerance and safety of the enriched formula.

Main Methods:

  • Randomized controlled trial involving infants with respiratory failure due to RSV-bronchiolitis.
  • Comparison of a protein and energy-enriched formula (PE-formula) versus a standard formula (S-formula).
  • Study duration of 5 days post-admission, monitoring nutrient intake, balance, and amino acid levels.

Main Results:

  • Infants receiving the PE-formula achieved higher nutrient intakes, meeting population reference intake (PRI) earlier than those on S-formula.
  • Significantly greater cumulative nitrogen balance (cNB) and energy balance (cEB) were observed in the PE-formula group (P<0.01).
  • Essential amino acid levels were higher in PE-fed infants, remaining within reference limits, unlike in S-fed infants.

Conclusions:

  • Early use of protein and energy-enriched formula in critically ill infants is well-tolerated.
  • Enriched formula promotes adequate nutrient intake and improves energy and nitrogen balance.
  • No adverse effects were observed, suggesting a safe and effective nutritional strategy.
Abstract

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