Effects of high protein, arginine, and glutamine supplementation to enteral nutrition on pressure ulcers in critically ill patients: A preliminary report

• Published in: Journal of critical care 2024-06, Vol.81, p.154638, Article 154638
• Main Authors: Ferlicolak, Leyla, Erener, Merve Erdogan, Altintas, Neriman Defne
• Format: Article
• Language: English
• Subjects: Critical care; Elderly; ICU; Nutrition; Pressure ulcers; Proteins; Wound healing
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2024.154638

It is well known that pressure ulcers (PUs) especially those in elderly critically ill patients are a major problem. The presence of PUs in critically ill has an impact on nutritional treatment as a result of the increased metabolic demand for repairing tissue damage. The aim of this study was to evaluate the effect of nutrition supplemented with high protein, arginine, and glutamine on PUs in critically ill patients. We evaluated the data of critically ill patients with PUs on admission, who were fed enterally with high protein, arginine, and glutamine (Impact Glutamin®) between October 2022–March 2023. We prescribed study formula when patients were hemodynamically stable, without shock state and after a period of feeding with a standard formula. Totally 9 patients were treated with the study formula. The mean age was 87 and 5(55%) were female. Mean Charlson Comorbidity Index was 7.4, APACHE II score was 25 and admission SOFA score was 7.4. The most common admission diagnosis was acute respiratory failure and invasive mechanical ventilation requirement was in 7(77%) patients. Except for one patient, all had a high risk for malnutrition (mean mNUTRIC score was 6.5). The mean body mass index was 23. After the initiation of the specific nutrition formula, we observed decreasing the grade of PUs in the first week and PUs area reduction in the third week The healing time of the PUs in critically ill patients is shortened with high protein, arginine, and glutamine supplemented nutrition. Although standard care of PUs with the usage of appropriate wound care products, and regularly changing the patients' position, are the main treatment, special nutrition formulas could be effective in the treatment.