PP229 Implementation of the Current Pre
112
Poster presentations
with less hypoglycemia (2% SPRINT vs 7.7% and 2.9% for
Glucontrol-A,B). SPRINT had less BG < 3.0 mmol/L and less
hyperglycemia (BG > 8.0 mmol/L).
Conclusion: Protocols that dose insulin “blind” to
carbohydrate administration suffer greater glycemic
variability, even if cohort-wide glycemic targets are met.
TGC protocols must be explicitly designed to account for
carbohydrate administration to minimise BG variability
and thus mortality outcomes across cohorts and/or
centres.
Disclosure of Interest: None declared
PP228
SUPPLEMENTAL PARENTERAL NUTRITION (SPN) IN ICU
PATIENTS FOR EARLY COVERAGE OF ENERGY TARGET:
SECOND PRELIMINARY REPORT OF A BI-CENTRIC,
PROSPECTIVE, CONTROLLED, RANDOMIZED STUDY
R. Thibault1 , C.P. Heidegger2 , S. Graf1 , M. Marin Caro1 ,
P. Darmon1 , V. Brancato3 , M.M. Berger3 , C. Pichard1 .
1
Unit´
e de Nutrition, 2 Intensive Care, Geneva University
Hospital, Geneva, 3 Intensive Care, University Hospital
Center (CHUV), Lausanne, Switzerland
Rationale: Enteral nutrition (EN) does not achieve
targeted nutritional goals in ICU patients. The study
investigates the feasibility to deliver 100% of the energy
and protein target from day 4 after admission by SPN.
Methods: The inclusion criteria were mean energy
delivery of the 3 first days 5 days, expected
survival >7 days, no contraindication to EN, patients not
receiving PN, age >18 y. We included 211 patients, then
excluded 26 patients; 185 patients were randomized to
receive EN alone (“EN group”, n = 99) according to local
practice, or EN+SPN (“SPN group”, n = 86) consisting in
using PN to reach the energy target if EN is insufficient.
Energy target was adjusted by indirect calorimetry in
64% of patients. Protein target was calculated as 1.3 g/kg
actual body weight/day.
Results: At inclusion, EN and SPN groups were similar for
age (mean±SD, 60±16 vs 62±16), gender (79/30 men
vs 76/26), BMI (26.5±4.5 vs 26.4±4.4) and SOFA (7±3
vs 6±4). Patients were admitted for cardiogenic shock
(30%), sepsis (19%), trauma injury (15%), brain surgery
(12%) and other diagnosis (24%).
Energy (ED) and protein (PD) delivery, expressed as mean±SD (%
target)
EN (n = 99)
SPN (n = 86)
P value*
ED d4
PD d4
ED d5
PD d5
ED d6
PD d6
ED d7
PD d7
ED d8
PD d8
ED d4 8
PD d4 8
62±31
52±28
96±25
85±27
Poster presentations
with less hypoglycemia (2% SPRINT vs 7.7% and 2.9% for
Glucontrol-A,B). SPRINT had less BG < 3.0 mmol/L and less
hyperglycemia (BG > 8.0 mmol/L).
Conclusion: Protocols that dose insulin “blind” to
carbohydrate administration suffer greater glycemic
variability, even if cohort-wide glycemic targets are met.
TGC protocols must be explicitly designed to account for
carbohydrate administration to minimise BG variability
and thus mortality outcomes across cohorts and/or
centres.
Disclosure of Interest: None declared
PP228
SUPPLEMENTAL PARENTERAL NUTRITION (SPN) IN ICU
PATIENTS FOR EARLY COVERAGE OF ENERGY TARGET:
SECOND PRELIMINARY REPORT OF A BI-CENTRIC,
PROSPECTIVE, CONTROLLED, RANDOMIZED STUDY
R. Thibault1 , C.P. Heidegger2 , S. Graf1 , M. Marin Caro1 ,
P. Darmon1 , V. Brancato3 , M.M. Berger3 , C. Pichard1 .
1
Unit´
e de Nutrition, 2 Intensive Care, Geneva University
Hospital, Geneva, 3 Intensive Care, University Hospital
Center (CHUV), Lausanne, Switzerland
Rationale: Enteral nutrition (EN) does not achieve
targeted nutritional goals in ICU patients. The study
investigates the feasibility to deliver 100% of the energy
and protein target from day 4 after admission by SPN.
Methods: The inclusion criteria were mean energy
delivery of the 3 first days 5 days, expected
survival >7 days, no contraindication to EN, patients not
receiving PN, age >18 y. We included 211 patients, then
excluded 26 patients; 185 patients were randomized to
receive EN alone (“EN group”, n = 99) according to local
practice, or EN+SPN (“SPN group”, n = 86) consisting in
using PN to reach the energy target if EN is insufficient.
Energy target was adjusted by indirect calorimetry in
64% of patients. Protein target was calculated as 1.3 g/kg
actual body weight/day.
Results: At inclusion, EN and SPN groups were similar for
age (mean±SD, 60±16 vs 62±16), gender (79/30 men
vs 76/26), BMI (26.5±4.5 vs 26.4±4.4) and SOFA (7±3
vs 6±4). Patients were admitted for cardiogenic shock
(30%), sepsis (19%), trauma injury (15%), brain surgery
(12%) and other diagnosis (24%).
Energy (ED) and protein (PD) delivery, expressed as mean±SD (%
target)
EN (n = 99)
SPN (n = 86)
P value*
ED d4
PD d4
ED d5
PD d5
ED d6
PD d6
ED d7
PD d7
ED d8
PD d8
ED d4 8
PD d4 8
62±31
52±28
96±25
85±27