Implementation and issues of a nutritional therapy protocol for severe sepsis/septic shock patients treated with renal replacement therapy

Abstract

【Objective】 In this study, we investigated the outcomes and issues associated with a nutritional therapy protocol for severe sepsis/septic shock patients treated with renal replacement therapy. 【Methods】 We retrospectively compared the patients who survived (32 cases) with those who died (16 cases). 【Results】 The mean starting times of enteral nutrition (EN) did not differ significantly between the two groups. The rates of energy and protein intake on day 10 were 111.9±11.7％ (EN: 93.7±18.6%) and 1.3±0.2g among the patients who survived and 112.4±19.9% (EN: 86.0±28.4%) and 1.3±0.4g among the patients who died. The cumulative fluid balance was significantly higher among the patients who died than among those who survived. The secondary infection rates tended to be higher among the patients who died. The white blood cell count and the C-reactive protein level on day 14 were significantly higher among the patients who died. The total protein and the albumin level on day 14 were significantly lower among the patients who died. 【Conclusion】 Implementation of the mainly EN protocol enabled the energy requirements of patients to be met, regardless of disease severity.