How transplant patients are fed in the intensive care unit: A one-year retrospective study

Even though the nutritional status of patients following organ transplant has a significant effect on outcomes, the energy intake of transplant patients hospitalized in the intensive care department is not well reported. The present study aims to examine the medical nutritional therapy of transplant patients in a large transplant center.

Data were collected retrospectively. All patients after perioperative transplant surgery or with late complications after organ transplants were included. The study included 78 patients who underwent liver (n=36), kidney (n=21), lung (n=14), pancreas (n=3) or both pancreas and kidney (n=4) transplants in 2017. Energy requirements were predicted using the Faisy-Fagon predictive equations calculated daily for 14 days. Energy intake was assessed, and daily energy balance was calculated. Complications and mortality were noted.

The mean energy intake was 1150 kcal/day. Most patients were in a negative energy balance (NEB; range -5735 to 3437 kcal/day). A greater NEB was associated with longer length of ventilation (LOV) and length of stay (LOS). The observed mortality rate was 42.3%. The correlation between energy balance (14 days) and LOS was r=-0.549; for LOV, it was r=-0.569. Patients who underwent lung transplant had the highest negative energy balance and the highest mortality (p<0.01).

Most of the transplant patients were underfed, and there was a significant correlation between energy balance and mortality (r=-0.324). Optimal energy intake should be assessed prospectively.