Non-Protein Calorie: Nitrogen Ratio (NPC/N) as an Indicator of Nitrogen Balance in Clinical Settings
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 6, Issue 1
Abstract
Background: An energy and protein provisions to patients in clinical settings, with not only acute but non-acute illnesses, have been reported an essential to prevent body mass wasting if they are provided sufficiently. A malnutrition observed in acute and chronic illnesses is more or less resulted from an inflammation. Methods:We set three clinical questions to analyze: a) To which extents is protein provision sufficient to prevent adverse events in nutritional management, b) Is there any relevant indicator to prevent muscle loss, c) If it exists, is there any explanation to make clear the mechanism hidden behind it? Results: a) 1.2-1.5 gram protein per kg of preadmission body weight was defined optimal target. b) There was a significant relation between total protein loss and calorie: N ratio. Additionally, non-protein calorie: N (NPC/N) ratio were also proposed as indicators of N balance in the literatures. c) The hormonal and metabolic reactions to starvation and stress were studied to ensure the mechanism hidden behind these sequences. Conclusions: From the review of the literatures, we would propose NPC/N ratio as a clinically feasible indicator of nitrogen balance to prevent muscle loss or adverse events to prevent in patients with acute and non-acute illnesses. An energy and protein provisions to patients in clinical settings, not only in acute but in non-acute, have been reported essential to prevent body mass losing if provided sufficiently [1]. A malnutrition still frequently observed in acute and chronic illnesses could be identical, more or less, to an inflammation observed as main cause of malnutrition [2]. Under inflammatory circumstances, pro-inflammatory cytokine storm on skeletal muscles insults on muscle to result in loss of muscle mass and cachexic sequences occurs [3]. In these contexts, insufficient energy and protein managements in patients with acute or non-acute illnesses have been reported to have an impact on morbidity and mortality [4-6]. In other words, an appropriate nutritional management with sufficient energy and protein might prevent muscle loss and poor outcome.
Authors and Affiliations
Teruyoshi Amagai, Mari Hasegawa, Moeko Kitagawa, Seiji Haji
Keywords
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- EP ID EP592288
- DOI 10.26717/BJSTR.2018.06.001297
- Views 157
- Downloads 0
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