Energy balance
During early critical illness, intramuscular lipid delivery (from enteral or parenteral nutrition) is bioenergetically inert and does not contribute to ATP content or muscle mass preservation.
In the first week of critical illness, standard lipid-based nutrition does not appear to fuel muscle energy or prevent muscle loss because the muscle's mitochondria are dysfunctional. This suggests that early lipid delivery may be ineffective for muscle preservation in this specific acute phase.
ATP content and muscle mass were unrelated to lipids delivered... These data suggest that current critical care nutritional management is unable to prevent development of an impaired bioenergetics status... These findings thus offer a plausible explanation for the apparent conflict between data from observational studies demonstrating a clinical benefit from increased nutrition over the entire ICU stay and the lack of benefit observed with early targeted nutrition.
Why this rating
Observational cohort study with serial biopsies and network analysis; strong internal validity for the specific population but not a randomized intervention trial of lipid exclusion.
Source
Metabolic phenotype of skeletal muscle in early critical illness
Zudin Puthucheary et al. · Thorax · 2018
DOI 10.1136/thoraxjnl-2017-211073
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