The clinical impacts of early using glutamine/arginine enriched high protein density formula at trophic dose in intolerant enteral nutrition cachectic hypoalbuminemic hospitalized patients.

BACKGROUND: We sought to evaluate the clinical impacts of the early administration of trophic doses of a glutamine/arginine enriched enteral nutrition formula (ENF) with a high protein density to cachectic hypoalbuminemic hospitalized patients intolerant to enteral nutrition.

METHODS: A retrospective analysis was conducted using the nutritional and non-nutritional data of patients admitted to our institution from April 2017 through August 2019. Patients who died or were discharged before completing ≥1 weeks of hospital admission, or those whose data could not be obtained were excluded. Among other variables, percent changes in serum albumin levels (%∆ALB), C - reactive protein (CRP) and their ratios were expressed as Mean±SD using the Independent Samples T-test, while categorical variables were expressed as numbers with percentages by using χ2 test. Two tested groups were determined based on the use of ENF: Group I received trophic doses of ENF, while Group II received no enteral nutrition.

RESULTS: The overall hospital length of stay (LOS) and overall 28-day hospital mortality were significantly lower in Group I when compared with Group II with Means±SDs of (11.32±2.19 days vs 23.49±4.33 days) and (13.13% vs. 28.16%), respectively. Also, significantly higher (%∆ALB) for Group I compared with group II (43.48%±7.89% vs. 33.45%±6.18%), respectively was observed.

CONCLUSION: In malnourished hypoalbuminemic patients suffering from feeding intolerance, early trophic administration of glutamine/arginine enriched high protein density ENF was well tolerated and may be associated with increased plasma albumin levels, reduced LOS, and overall 28-day mortality, and hence may be considered in such patients.