@entity6 -specific enteral nutrition formula in XXXX , mechanically ventilated, @entity3124 @entity1 : a prospective, open-label, blind-randomized, multicenter study.

@entity1 @entity6 @entity55 @entity3124 @entity177 @entity281 @entity1602 @entity413 @entity288
INTRODUCTION: Although standard enteral nutrition is universally accepted, the use of disease-specific formulas for @entity1602 @entity1 is still controversial. This study examines whether a high-protein @entity6 -specific formula reduces insulin needs, improves glycemic control and reduces ICU-acquired @entity281 in @entity3124 , @entity1602 @entity1 on mechanical ventilation (MV). METHODS: This was a prospective, open-label, randomized (web-based, blinded) study conducted at nine Spanish ICUs. The @entity1 groups established according to the high-protein formula received were: group A, new-generation @entity6 -specific formula; group B, standard control formula; group C, control @entity6 -specific formula. Inclusion criteria were: expected enteral nutrition >= 5 days, MV, baseline @entity413 >126 mg/dL on admission or >200 mg/dL in the first 48 h. Exclusion criteria were: APACHE II  <=10, @entity177 , treatment with @entity288 , immunosuppressants or lipid-lowering drugs and body mass index >= 40 kg/m(2). The targeted @entity413 level was 110-150 mg/dL. Glycemic variability was calculated as the standard deviation, glycemic lability index and coefficient of variation. Acquired @entity281 were recorded using published consensus criteria for @entity3124 @entity1 . Data analysis was on an intention-to-treat basis. RESULTS: Over a 2-year period, 157 @entity1 were consecutively enrolled (A 52, B 53 and C 52). Compared with the standard control formula, the new formula gave rise to lower insulin requirement (19.1        13.1 vs. 23.7        40.1 IU/day, p <0.05), plasma @entity413 (138.6        39.1 vs. 146.1        49.9 mg/dL, p <0.01) and capillary blood @entity413 (146.1        45.8 vs. 155.3        63.6 mg/dL, p <0.001). Compared with the control @entity6 -specific formula, only capillary @entity413 levels were significantly reduced (146.1        45.8 vs. 150.1        41.9, p <0.01). Both specific formulas reduced capillary @entity413 on ICU day 1 (p <0.01), @entity413 variability in the first week (p <0.05), and incidences of ventilator-associated tracheobronchitis (p <0.01) or @entity55 (p <0.05) compared with the standard formula. No effects of the nutrition formula were produced on hospital stay or mortality. CONCLUSIONS: In these high-risk ICU @entity1 , both @entity6 lowered insulin requirements, improved glycemic control and reduced the risk of acquired @entity281 relative to the standard formula. Compared with the control-specific formula, the new-generation formula also improved capillary glycemia. TRIAL REGISTRATION: Clinicaltrials.gov NCT1233726 .
