Background & aims: High protein delivery during early critical illness is associated with lower mortality, while energy overfeeding is associated with higher mortality. Protein-to-energy ratios of traditional enteral formulae are sometimes too low to reach protein targets without energy overfeeding. This prospective feasibility study aimed to evaluate the ability of a new enteral formula with a high protein-to-energy ratio to achieve the desired protein target while avoiding energy overfeeding.Methods: Mechanically ventilated non-septic patients received the high protein-to-energy ratio nutrition during the first 4 days of ICU stay (n = 20). Nutritional prescription was 90% of measured energy expenditure. Primary endpoint was the percentage of patients reaching a protein target of ≥1.2 g/kg ideal body weight on day 4. Other endpoints included a comparison of nutritional intake to matched historic controls and the response of plasma amino acid concentrations. Safety endpoints were gastro-intestinal tolerance and plasma urea concentrations. Results: Nineteen (95%) patients reached the protein intake target of ≥1.2 g/kg ideal body weight on day 4, compared to 65% in historic controls (p = 0.024). Mean plasma concentrations of all essential amino acids increased significantly from baseline to day 4. Predefined gastro-intestinal tolerance was good, but unexplained foul smelling diarrhoea occurred in two patients. In one patient plasma urea increased unrelated to acute kidney injury. Conclusions: In selected non-septic patients tolerating enteral nutrition, recommended protein targets can be achieved without energy overfeeding using a new high protein-to-energy ratio enteral nutrition.
MULTIFILE
Background & aims: High protein delivery during early critical illness is associated with lower mortality, while energy overfeeding is associated with higher mortality. Protein-to-energy ratios of traditional enteral formulae are sometimes too low to reach protein targets without energy overfeeding. This prospective feasibility study aimed to evaluate the ability of a new enteral formula with a high protein-to-energy ratio to achieve the desired protein target while avoiding energy overfeeding.Methods: Mechanically ventilated non-septic patients received the high protein-to-energy ratio nutrition during the first 4 days of ICU stay (n = 20). Nutritional prescription was 90% of measured energy expenditure. Primary endpoint was the percentage of patients reaching a protein target of ≥1.2 g/kg ideal body weight on day 4. Other endpoints included a comparison of nutritional intake to matched historic controls and the response of plasma amino acid concentrations. Safety endpoints were gastro-intestinal tolerance and plasma urea concentrations. Results: Nineteen (95%) patients reached the protein intake target of ≥1.2 g/kg ideal body weight on day 4, compared to 65% in historic controls (p = 0.024). Mean plasma concentrations of all essential amino acids increased significantly from baseline to day 4. Predefined gastro-intestinal tolerance was good, but unexplained foul smelling diarrhoea occurred in two patients. In one patient plasma urea increased unrelated to acute kidney injury. Conclusions: In selected non-septic patients tolerating enteral nutrition, recommended protein targets can be achieved without energy overfeeding using a new high protein-to-energy ratio enteral nutrition.
MULTIFILE
De postdoc kandidaat, Tanja Moerdijk, zal op structurele wijze de reeds door haar gemaakte verbinding tussen het lectoraat Marine Biobased Specialties (MBBS) en de opleiding Chemie van HZ University of Applied Sciences verder uitbouwen en bestendigen. Streven is dat het MBBS Bioprospecten onderzoek zichtbaar is in alle studiejaren van de opleiding Chemie en praktijkcasuïstiek structureel ingebracht wordt in het curriculum. De postdoc is daarom betrokken bij alle studiejaren van de opleiding. Zij zal de ontwikkeling van een geïntegreerde onderzoeksleerlijn in het Chemie curriculum coördineren, welke gevoed wordt vanuit het MBBS onderzoeksprogramma waardoor inbedding van onderzoek in de opleiding wordt geborgd. Verdieping, overdracht en deling van kennis met betrekking tot het chemische smaak- en textuurprofiel van zeewier zal uitgevoerd worden door zowel postdoc als studenten door te participeren in het uitvoeren van praktijkgericht onderzoek aan (polymeer)moleculen uit zeewier in samenwerking met de zeewierproducenten. Deze kennis zal uiteindelijk bijdragen aan een duurzame productie en verwerking van zeewier tot eindproducten voor de consument. Omdat het onderwerp breed en maatschappelijke relevant is, creëert het bovendien de mogelijkheid voor andere opleidingen en onderzoeksgroepen om de verbinding eenvoudig te kunnen oppakken. De postdoc gaat de daadwerkelijke verbinding maken tussen onderzoekers, docenten en studenten. De postdoc ontwikkelt tevens projectleiderschapsvaardigheden door het volgen van een training en door lopende projecten binnen het MBBS onderzoek te benutten om samenwerking met (inter)nationale kennisinstellingen en bedrijven uit te bouwen. De postdoc zal begeleid en ondersteund worden in de uitvoering van haar activiteiten door lector en opleidingscoördinator (olc) (onder andere on the job en formele planningsafspraken), Centre of Expertise Biobased Economy (CoE BBE) alsmede het HZ kernteam CoE BBE (uitbouwen netwerk). Het personeelsbeleid en functiereeks onderwijs en onderzoek van de HZ voorzien in de ontwikkelingsmogelijkheid van de postdoc.
Proteins are nature-derived molecules that have found wide applications in biotechnology, pharmaceuticals and biocatalysis. A major limitation for the use of proteins in such applications is their lack of stability. This is due to the disruption of the tertiary structure of a protein, which is responsible for the function of a protein. Earlier studies have shown that three cysteine residues, which are strategically incorporated in the sequence, can be crosslinked with a tris-electrophile. This so-called in situ cyclization of proteins (INCYPRO) results in the rigidification of the protein structure and ultimately higher stability of the protein. For some proteins, it would be beneficial to use another amino acid residue for modification as cysteine residues can be important for the function of a protein, e.g. as disulfide bridges or as active sites residues. In this project, we will develop crosslinkers that are selective for methionine residues. Although these amino acids contribute to the function of proteins in biological systems, they are less important for the molecular function of proteins, thus making them suitable for crosslinking of proteins. Our plan is to first develop a set of trisfunctionalized crosslinkers that selectively react with the thioether functional group of methionine. Next, we will investigate the crosslinking conditions on the model protein (KIX domain) as a proof of concept. In the final step, we would like to prove that the function of the protein is retained by crosslinking the transpeptidase enzyme sortase A.