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Propofol Use Precludes Prescription of Estimated Nitrogen RequirementsDepartment of Nutrition and Dietetics, Frenchay Hospital, Bristol, BS16 1LE, UK dusk{at}gotadsl.co.uk
Intensive Care Unit, Frenchay Hospital, Bristol, UK
Department of Anaesthetics, Frenchay Hospital, Bristol, UK The objective was to determine whether reducing enteral nutrition to accommodate 1% Propofol-derived energy results in suboptimal nitrogen prescription. This was a prospective observational study of 85 consecutive patients requiring mechanical ventilation and receiving 1% Propofol. Enteral nutrition prescription often failed to meet nitrogen requirements (<90%, in 50.6%; <80%, in 21.1%), whereas fat provided 51% of total energy input, exceeding 2 g fat/kg/d in 20%. However, gastroparesis was common, resulting in suboptimal nutrition (median of requirements: energy 71%; nitrogen 57%). If energy balance had been strictly maintained, substituting 1% with 2% Propofol would reduce the number of patients failing to meet nitrogen requirements (1% vs 2%: <90%: in 58.8% vs 17.6%,P< .001; <80% in 35.3% vs 4.7%,P< .014). These effects are directly related to the amount of fat delivered with Propofol. Intensive care unit–associated gastroparesis commonly reduces enteral nutrition input. However, even where this is overcome, use of 1% Propofol frequently precludes prescription of estimated nitrogen requirements; either 2% Propofol or a non-Propofol alternative should be considered.
Key Words: Propofol • Intralipid • nitrogen • glucose • enteral nutrition • nutritional requirements
Journal of Intensive Care Medicine, Vol. 20, No. 2,
111-117 (2005) This article has been cited by other articles:
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