Critical Care

, 19:P399 | Cite as

Early calorie-dense immune nutrition in haemodynamically compromised cardiac patients

  • S Efremov
  • V Lomivorotov
Open Access
Poster presentation


Transferrin Enteral Nutrition Acute Heart Failure Cardiac Patient Indirect Calorimetry 
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The aims of present study were to test the hypothesis that early enteral nutrition (EN) with calorie-dense food supplemented with glutamine improves recovery of nutritional status in critically ill cardiac patients and to evaluate their resting energy expenditure (REE).


A prospective randomised study of 40 adult cardiac patients undergoing elective cardiopulmonary bypass surgery no more than 24 hours before eligibility assessment, complicated with acute heart failure syndrome. Patients were randomised to receive either standard isocaloric isonitrogenic early EN (standard group, n = 20) or immunomodulating early EN (immune group, n = 20). The daily energy target was set using REE measured by indirect calorimetry (CCM Express; Medgraphics, St. Paul, MN, USA). Serum prealbumin, transferrin, C-reactive protein, blood lactate and clinical characteristics were analysed.


The actual REE was an average of 6.8 and 7.5 kcal/kg/day higher than the REE calculated using the Harris-Benedict equation and empiric approach (25 kcal/kg/day), respectively (Figure 1). Early EN with immune formula was associated with higher levels of prealbumin concentration on the 14th day (0.13 ± 0.01 g/l and 0.21 ± 0.1 g/l; P = 0.04) and transferrin on the 3rd, 5th, 7th, and 14th day (P < 0.05) after surgery.
Figure 1

Indirect calorimetry measured significantly higher resting energy expenditures.


Haemodynamically compromised cardiac patients have increased REE, which in the absence of indirect calorimetry should be set at 30 kcal/kg/day. Early EN using a calorie-dense immune formula leads to better recovery of nutritional status as assessed by serum protein levels.

Copyright information

© Efremov and Lomivorotov; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

Authors and Affiliations

  • S Efremov
    • 1
  • V Lomivorotov
    • 1
  1. 1.Research Institute of Circulation PathologyNovosibirskRussia

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