This study focuses on understanding how well patients who have recovered from an ICU stay absorb nutrients when receiving enteral (tube) feeding. Proper nutrition is crucial for recovery, but we don't fully understand how efficiently enteral feeding works in ICU survivors. The study will use advanced techniques like bomb calorimetry to measure the energy content of stool, and indirect calorimetry to measure patients' resting energy expenditure (REE). This will help assess the effectiveness of enteral feeding in these patients, providing valuable information about their metabolic needs and nutritional status.
The study will also look into the environmental impact of enteral feeding, particularly food waste. By understanding how much of the nutrition is absorbed versus excreted, the study hopes to suggest more sustainable feeding practices and reduce unnecessary waste in hospitals.
Key Goals:
* Primary Goal: Measure how much energy from enteral feeding is absorbed by patients post-ICU by analyzing their stool and energy expenditure. * Secondary Goal: Assess how enteral feeding can be made more sustainable, with less waste generated from unused nutritional products.
This research will help improve nutritional care for ICU patients, enhance recovery, and potentially lead to more environmentally friendly healthcare practices.
age of 18 years or older
minimum ICU stay of 7 days
fully dependent on enteral feeding (nasogastric or PEG-tube)
ability of the patient or representative to understand and sign written informed consent in Dutch, French or English
known inflammatory bowel disease
known malabsorptive gastrointestinal disease
history of small bowel resection
concomitant use of serotoninergic or sympathomimetic medications (oa. setrone, tryptans, antidepressants, methylphenidate, monoamine oxidase inhibitors, tramadol)
Single group
caloric intake measurement
Other interventionDetailed daily tracking of the enteral feeding provided to each patient, inclusing the type and amount of nutritional formula administered. Apart from the enteral intake, supplemental calories provided by infusion (e.g. glucose) will be recorded to ensure accurate measurement of caloric intake.
stool sample collection
Procedure/Surgery* a nonabsorbable blue dye marker will be administered at the start and end of the stool collection period to precisely indentify the stool produced within a specific time frame. * stool will be collected for three days. Each sample will be collected, weighted and labeled with the date and time, then stored at -20°C. * only stool samples from the appearance of the first dye marker to the appearance of the second dye marker will be saved and analyzed. * bomb calorimetry preparation * blending and dilution: each stool sample will be put into a blender and mixed with an equal amount of water * freeze dying: the diluted stool will be placed into freeze-dye flasks and frozen at -20°C. The next day, the flasks will be placed into a freeze dryer for 48hours. * pellet formation: the freeze-dried samples will be formed into 1-gram pellets and stored until calorimetry * calorimetry analysis: the Parr 6200 isoperibol calorimeter will be used to measure the energy content of the stool pellets
energy expenditure measurement
Other interventionperforming indirect calorimetry to measure the REE of each patient
caloric absorption efficiency
the caloric intake from enteral feeding will be compared with the caloric content of the excreted stool. The difference between these two values will provide an estimate of how efficiently the body absorbs the administered nutrients.
Resting Energy Expenditure (REE)
The study will measure the resting energy expenditure of post-ICU patients using indirect calorimetry, which provides a real-time measure of the patients' basal metabolic rate and energy needs.
Nutrient Absorption Efficiency
The proportion of the enteral nutrition that is absorbed by the patient will be compared to the total amount administered. A higher absorption efficiency would suggest less wasted nutrition and better utilization of the enteral feeding.
Waste Generation from Enteral Feeding Solutions and Tubing
The study will evaluate the quantity of waste produced from the daily replacement of enteral feeding solutions and tubing. This measure will provide insight into the sustainability impact of current practices and how much material is being discarded in hospital settings.
Overall Food Waste in Hospitals
The study will quantify the amount of enteral nutrition that is not consumed, absorbed, or excreted. This includes any nutrition that is wasted due to feeding inefficiencies or patient non-consumption.
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Universitair Ziekenhuis Brussel
Lead sponsor
Société des Produits Nestlé (SPN)
Collaborator
