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Publication Details

Title :

Free Fatty Acids’ Level and Nutrition in Critically Ill Patients and Association with Outcomes: A Prospective Sub-Study of PermiT Trial.

Journal:

Nutrients.

Impact Factor:

4.196

Authors:

Arabi YM1,2, Tamimi W3,4, Jones G5, Jawdat D6, Tamim H7,8, Al-Dorzi HM9,10, Sadat M11,12, Afesh L13, Sakhija M14,15, Al-Dawood A16,17.

Affiliations:

1 College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia. yaseenarabi@yahoo.com.

2 Intensive Care Department, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia. yaseenarabi@yahoo.com.

3 College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia. TamimiW@NGHA.MED.SA.

4 Department of Clinical Laboratory, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia. TamimiW@NGHA.MED.SA.

5 Department of Medicine, Division of Critical Care Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ottawa KIH 8L6, Canada. GJones@ottawahospital.on.ca.

6 College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Cord Blood Bank, King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia. JawdatD@NGHA.MED.SA.

7 Department of Internal Medicine, American University of Beirut-Medical Center, Beirut 110-236, Lebanon. hani_t@hotmail.com.

8 King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia. hani_t@hotmail.com.

9 College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia. aldorziha@NGHA.MED.SA.

10 Intensive Care Department, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia. aldorziha@NGHA.MED.SA.

11 College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia. sadatmu@ngha.med.sa.

12 Intensive Care Department, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia. sadatmu@ngha.med.sa.

13 King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia. Afeshla@ngha.med.sa.

14 College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia. SakkijhaM@NGHA.MED.SA.

15 Intensive Care Department, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia. SakkijhaM@NGHA.MED.SA.

16 College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia. dawooda@ngha.med.sa.

17 Intensive Care Department, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia. dawooda@ngha.med.sa.

 

Year of Publication:

2019

DOI:

10.3390/nu11020384.

Abstract:

OBJECTIVES:

The objectives of this study were to evaluate the clinical and nutritional correlates of high free fatty acids (FFAs) level in critically ill patients and the association with outcomes, and to study the effect of short-term caloric restriction (permissive underfeeding) on FFAs level during critical illness.

PATIENTS/METHOD:

In this pre-planned sub-study of the PermiT (Permissive Underfeeding vs. Target Enteral Feeding in Adult Critically Ill Patients) trial, we included critically ill patients who were expected to stay for ≥14 days in the intensive care unit. We measured FFAs level on day 1, 3, 5, 7, and 14 of enrollment. Of 70 enrolled patients, 23 (32.8%) patients had high FFAs level (baseline FFAs level >0.45 mmol/L in females and >0.6 mmol/L in males).

RESULTS:

Patients with high FFAs level were significantly older and more likely to be females and diabetics and they had lower ratio of partial pressure of oxygen to the fraction of inspired oxygen, higher creatinine, and higher total cholesterol levels than those with normal FFAs level. During the study period, patients with high FFAs level had higher blood glucose and required more insulin. On multivariable logistic regression analysis, the predictors of high baseline FFAs level were diabetes (adjusted odds ratio (aOR): 5.36; 95% confidence interval (CI): 1.56, 18.43, p = 0.008) and baseline cholesterol level (aOR, 4.29; 95% CI: 11.64, 11.19, p = 0.003). Serial levels of FFAs did not differ with time between permissive underfeeding and standard feeding groups. FFAs level was not associated with 90-day mortality (aOR: 0.49; 95% CI: 0.09, 2.60, p = 0.40).

CONCLUSION:

We conclude that high FFAs level in critically ill patients is associated with features of metabolic syndrome and is not affected by short-term permissive underfeeding.