Abstract

GONZALEZ CARMONA, Brenda Gabriela; MONARES ZEPEDA, Enrique  and  JIMENEZ CASILLAS, Alejandro Valentín. Prediction of protein catabolism without using 24-hour urine collection urea nitrogen excretion in critical ill patients. Rev. Asoc. Mex. Med. Crít. Ter. Intensiva [online]. 2015, vol.29, n.1, pp.8-12. ISSN 0187-8433.

Introduction: Nutrition support provided to the critical ill patient is an effort to prevent loss of nitrogen in the hyper-catabolic phase of the insult and also to promote restoration of the protein mass in the recovery period. Therefore it is important to accurately identify which patients have increased protein destruction and require aggressive early nutrition intervention, according to their daily nitrogen losses. Objective: Compare two formulas for determining the nitrogen balance level of the organism. The first formula using the 24-hour urinary urea nitrogen excretion, and the second formula using routine laboratory variables and anthropometric parameters as serum urea nitrogen (SUN mg/dL), actual body weight (WT) and white blood cells count (WBC cells/mm³) in the daily care of critical ill patients. Material and methods: A prospective, observational study conducted in the Department of Critical Care Medicine "Dr. Mario Shapiro", American British Cowdray Medical Center from March 2011 to February 2014. We compared two different methods to calculate nitrogen catabolism. Correlation index and Balant and Altman method was performed. Results: We considered a total of 380 cases that have inclusion criteria, 149 cases were analyzed using the two formulas mentioned below. The median age was 65 years, with median SAPS II score of 41 ± 11 points. The correlation index for the 2 formulas was 0.731, with a p < 0.05. Conclusions: The proposed formula does not need a 24-hour urinary urea nitrogen excretion to calculate nitrogen balance, it just need routine laboratory screens.

Keywords : Nitrogen balance; metabolism; catabolism.

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