Inflammatory Markers Related to Medical Nutritional Therapy in Critically Ill Patients in Intensive Care Unit: Study on CRP and Procalcitonin

Abstract

Background and objectives: Malnutrition is the most frequent complication in patients in an intensive care unit (ICU). CRP and Procalcitonin are used as acute phase inflammatory markers, adversely affecting patient outcomes. This study aims to determine the effect of medical nutritional therapy on the level of CRP and procalcitonin in critically ill patients. Methods: This study was a retrospective cohort design on critically ill patients at Wahidin Sudirohusodo Teaching Hospital from 2020-2021, 250 subjects met the inclusion criteria by screening for malnutrition using the m-Nutric score, CRP assessment using Flouroscene immune assay, procalcitonin using chemiluminescent microparticle immune assay, nutrition intake by 24-hours food recall, all patients received medical nutrition therapy. Results: This study showed patients with low grade m-Nutric score significantly decreased of CRP level (energy intake ≥ 600 kcal p=0.009) not for procalcitonin level (p=0.841), while procalcitonin tend to be significantly decreased (energy intake < 600 kcal p=0.054) not with CRP level (p=0.655). Patient with high-risk m-Nutric score showed significancy decreased procalcitonin level (energy intake ≥ 600 kcal p=0.011) while not for CRP (p=0.109) and procalciton (energy intake < 600 kcal p=0.138). Conclusion: Medical nutritional therapy with energy intake ≥ 600 kcal incritical ill decreased CRP level in a low risk m-Nutric score, and decreased procalcitonin level in a high risk m-Nutric score.