THE INFLUENCE OF NUTRITION ON MUSCLE WASTING IN CRITICALLY ILL PATIENTS – A PILOT STUDY

Introduction:Adequate nutrition is necessary to prevent muscle wasting in critically ill patients. Decision about enteral or parenteral nutrition is always questionable. Objective: The aim of our study was to assess the impact of nutrition on muscle wasting in critically ill patients with trauma injury. Material and methods: The study was conducted in the period from January to December 2017 and included 30critically ill patients with trauma injury hospitalized on the Intensive care unit (ICU) of the University clinic for anesthesiology and intensive care in Skopje. Included patients were divided into two groups: group E - patients where enteral nutrition was conducted after the third day of their admission in ICU and group P - patients where total parenteral nutrition was implemented in the first 24 hours of their admission. The study monitored the impact of two different types of nutrition on muscle wasting evaluated by ultrasound measurements of m.quadriceps femoris thickness and biochemical measurements of the serum creatinine level. Results: In group E there was statistically significant muscle wasting evaluated by ultrasound between the1st and the 3rd and the1st and the 7th day. Difference in measured muscle thickness was 1.90 ± 1.49 mm between the 1st and the 3rd (p = 0.015) and 4.46 ± 2.81 mm between the 1st and the 7th day (p = 0.006). In group P muscle wasting in the same period was without statistical significance. Both groups showed statistically significant decrease in serum creatinine levels between the 1st and the 3rd(p = 0.003, p = 0.03) and the 1st and 7th (p = 0.003) day. The values of differences between the 1st and the 3rd and the 1st and the 7th day were 7.57 ± 4.12 mg/dl and 10.71 ± 5.79mg/dl in group E and 11.43 ± 10.66 mg/dl and 15.28 ± 8.28 mg/dl in group P. Conclusion: In our study we determined a significant decrease of muscle mass evaluated by ultrasound measurements of m.quadriceps femoris thickness in patients with enteral nutrition after the third day