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