Pediatr Gastroenterol Hepatol Nutr.  2018 Oct;21(4):321-328. 10.5223/pghn.2018.21.4.321.

Prealbumin and Retinol Binding Proteins Are Not Usable for Nutrition Follow-Up in Pediatric Intensive Care Units

Affiliations
  • 1Pediatric Intensive Care Unit, Koru Hastanesi, Antalya, Turkey. tekguchakan@gmail.com
  • 2Biostatistics and Medical Informatics, Akdeniz University School of Medicine, Antalya, Turkey.
  • 3Nutrition and Dietician Department, Akdeniz University School of Medicine, Antalya, Turkey.
  • 4Clinical Biochemistry Department, Akdeniz University School of Medicine, Antalya, Turkey.
  • 5Pediatric Intensive Care Unit, Akdeniz University School of Medicine, Antalya, Turkey.

Abstract

PURPOSE
Feeding children is a problem in pediatric intensive care units (PICU) and it is difficult to know the correct amount. The purpose of this study is to evaluate if prealbumin or retinol binding proteins (RBP) are effective relative to daily enteral nutrition, without being affected by severity of diseases or infections and can be used to follow up nutritional amount.
METHODS
This is a prospective observational study that includes 81 patients admitted to PICU in Akdeniz University with estimated duration >72 hours, age between 1 month and 8 years. Daily calorie and protein intake were calculated and prealbumin, RBP and C-reactive protein (CRP) levels were measured on the first, third, fifth and seventh mornings.
RESULTS
We find moderate correlation between daily calorie intake and prealbumin levels (r=0.432, p < 0.001), RBP levels and daily protein intake (r=0.330, p < 0.001). When we investigated the relationship between changes of prealbumin, RBP, CRP, calorie and protein intake during intensive care stay, we found that increase of Prealbumin and RBP levels are explained by decrease of CRP levels (r=−0.546 and −0.645, p < 0.001) and not with increase of nourishment.
CONCLUSION
Even adjusted for PRISM3, age and CRP, prealbumin and RBP are correlated with last 24 hours' diet. However, it is not convenient to use as a follow up biomarker because increase of their levels is related with decrease of CRP levels.

Keyword

Nutritional status; Intensive care units; Child; Critical illness; Prealbumin; Retinol-binding proteins

MeSH Terms

C-Reactive Protein
Child
Critical Care
Critical Illness
Diet
Enteral Nutrition
Follow-Up Studies*
Humans
Intensive Care Units
Intensive Care Units, Pediatric*
Nutritional Status
Observational Study
Prealbumin*
Prospective Studies
Retinol-Binding Proteins*
Vitamin A*
C-Reactive Protein
Prealbumin
Retinol-Binding Proteins
Vitamin A

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