Early enteral nutrition is associated with reduced in-hospital mortality from sepsis in patients with sarcopenia

Koga, Yasutaka; Fujita, Motoki; Yagi, Takeshi; Todani, Masaki; Nakahara, Takashi; Kawamura, Y.; Kaneda, Kotaro; Oda, Yasutaka; Tsuruta, Ryosuke

doi:10.1016/j.jcrc.2018.06.026

Cited by 23 publications

(68 citation statements)

References 24 publications

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“…In extension to the assessment of nutritional risk, increasing attention is paid to the presence of sarcopenia, frailty and the associated impaired physical functioning, as they have been demonstrated to be important predictors of a longer ICU and hospital length of stay, post-discharge mortality, quality of life and lower likelihood to return to home, as summarised in greater detail in recent reviews (50)(51)(52) . Notably, sarcopenic patients might benefit from an intense nutritional therapy, as recently demonstrated by Koga et al (53) in a retrospective analysis, where sarcopenic patients supplied with early EN showed a reduced hospital mortality compared with those who did not receive early EN, while that effect was not visible in non-sarcopenic patients.…”

Section: Focus On the Right Patientsmentioning

confidence: 77%

Meeting nutritional targets of critically ill patients by combined enteral and parenteral nutrition: review and rationale for the EFFORTcombo trial

Hill

Heyland

Elke³

et al. 2020

Nutr. Res. Rev.

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While medical nutrition therapy is an essential part of the care for critically ill patients, uncertainty exists about the right form, dosage, timing and route in relation to the phases of critical illness. As enteral nutrition (EN) is often withheld or interrupted during the ICU stay, combined EN and parenteral nutrition (PN) may represent an effective and safe option to achieve energy and protein goals as recommended by international guidelines. We hypothesize that critically ill patients at high nutritional risk may benefit from such a combined approach during their stay on the intensive care unit (ICU). Therefore, we aim to test if an early combination of EN and high-protein PN (EN+PN) is effective in reaching calorie and protein goals in patients at high nutritional risk, while avoiding overfeeding. This approach will be tested in the here presented EFFORTcombo trial. Nutritionally high-risk ICU patients will be randomized to either high (≥2.2 mg/kg/d) or low protein (≤1.2 mg/kg/d). In the high protein group, the patients will receive EN+PN, in the low protein group, patients will be given EN alone. EN will be started in accordance to international guidelines in both groups. Efforts will be made to reach nutrition goals within 48–96 hours. The efficacy of the proposed nutritional strategy will be tested as an innovative approach by functional outcomes at ICU- and hospital-discharge, as well as at a 6-month follow-up.

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Section: Focus On the Right Patientsmentioning

confidence: 77%

Meeting nutritional targets of critically ill patients by combined enteral and parenteral nutrition: review and rationale for the EFFORTcombo trial

Hill

Heyland

Elke³

et al. 2020

Nutr. Res. Rev.

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“…According to a majority consensus vote, 8 papers from the primary literature collective were identified as the most important for pharmacy nutrition support practice. [6][7][8][9][10][11][12][13] An additional 13 articles comprising organizational guidelines, consensus, recommendation, and position papers included separately as important papers to our practice. [14][15][16][17][18][19][20][21][22][23][24][25][26] Of these 21 finalist publications, 5 were published in Journal of Parenteral and Enteral Nutrition,4 in Clinical Nutrition, 3 in Anesthesia & Analgesia, 2 in Nutrition in Clinical Practice, and 2 in New England Journal of Medicine.…”

Section: Resultsmentioning

confidence: 99%

Significant Published Articles for Pharmacy Nutrition Support Practice in 2018

et al. 2019

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Purpose: The purpose of this article is to assist the pharmacist engaged in nutrition support therapy in staying current with pertinent literature. Methods: Several clinical pharmacists engaged in nutrition support therapy compiled a list of articles published in 2018 considered important to their clinical practice. The citation list was compiled into a single spreadsheet where the author participants were asked to assess whether the article was considered important to nutrition support pharmacy practice. A culled list of publications was then identified whereby the majority of author participants (at least 5 of 8) considered the paper to be important. Guideline and consensus papers from professional organizations, important to practice but not scored, were also included. Results: A total of 117 articles were identified; 8 from the primary literature were voted by the group to be of high importance. An additional 13 organizational guidelines, position, recommendation, or consensus papers were also identified. The top-ranked articles from the primary literature were reviewed. Conclusion: We recommend that pharmacists engaged in nutrition support therapy be familiar with these articles as it pertains to their practice.

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“…Erken enteral nütrisyon ile enfeksiyona bağlı komplikasyonlarda ve yoğun bakım ünitesinde yatış süresinde belirgin azalma olduğunu gözlemişlerdir. Yakın zamanda, sarkopenik hastalarda erken enteral nütrisyonu araştıran bir çalışma gerçekleştirilmiştir (14). Erken enteral nütrisyon başlanan sarkopenik hastalarda, hastane içi mortalitenin azaldığını saptamışlardır ve bu hasta grubunda erken enteral nutrisyonun faydalı olabileceğini belirtmişlerdir (14).…”

Section: Discussionunclassified

“…Yakın zamanda, sarkopenik hastalarda erken enteral nütrisyonu araştıran bir çalışma gerçekleştirilmiştir (14). Erken enteral nütrisyon başlanan sarkopenik hastalarda, hastane içi mortalitenin azaldığını saptamışlardır ve bu hasta grubunda erken enteral nutrisyonun faydalı olabileceğini belirtmişlerdir (14). Tian ve ark., (15) yakın zamanlı bir meta-analiz de yoğun bakım hastalarının sağkalım sonuçlarını etkileyen faktörleri araştırmışlardır.…”

Section: Discussionunclassified

The Effect of Early Enteral Immunonutrition to Inflammatory Response for Intensive Care Patients

Çelik¹,

Edipoğlu²

2019

tybd

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Objective: Early enteral immunonutrition affects cytokine-dependent stress response, providing an optimal inflammatory and immune response in the dynamic process of SIRS through sepsis. In our study, we examined the inflammatory response of standard and glutamine products in the early and late nutrition regimen. Materials and Methods: Forty patients aged between 30 and 60 who needed ventilation support were randomly divided into 4 groups, namely standard early enteral (SE), standard late enteral (SG), early enteral immunonutrition (IE) and late enteral immunonutrition (IG). In early enteral nutrition groups, nutrition started within the first 24 hours of treatment and after 72 hours in the late groups. Prealbumin, albumin, CRP , IL-6, IL-10, APACHE II and mortality were calculated. Results: There was no difference in terms of demographics. We found a decrease in the prealbumin level in the SE group (p<0.05). There was a decrease in CRP levels in the IE and IG groups compared to SG group. There was an increase in SE group at 5 th and 7 th days (p<0.05). In terms of IL-6 levels, we found a decrease in the IE, SE, IG groups compared to SG group. In the IE group, IL-6 level was decreased compared to IG and SE groups at the 7 th day. IL-10 level in the IG group increased at 5 th and 7 th days. APACHE II scores at 5 th day were higher in the IG group compared to SG group. There was no difference in terms of mortality. Conclusion: It was concluded that glutamine-rich early enteral immunonutrition efficiently suppressed the systemic inflammatory response without affecting mortality and biochemical parameters.ÖZ Amaç: Erken enteral immünonütrisyon, sitokinlere bağlı oluşan stres yanıtta değişiklikler oluşturarak, sistemik enflamatuvar yanıttan, sepsise doğru gelişen dinamik süreçte optimal bir enflamatuvar ve immün yanıt oluşturup, sağkalımı arttırmada etkilidir. Çalışmamızda, kritik hastalarda standart ve glutamin içeren ürünlerin erken ve geç enteral beslenme rejiminde enflamatuvar yanıta etkilerini araştırdık. Gereç ve Yöntem: Ventilatör desteği gereksinimi olan 30-60 yaş arası, 40 hasta randomize edilip dört gruba ayrıldı. Grup SE; standart erken enteral, SG; standart geç enteral İE; erken enteral immünonütrisyon, İG; geç enteral immünonütrisyon grubu olarak belirlendi. Erken enteral gruplara 24 saat içinde nütrisyon başlanırken, geç gruplara 72 saat sonra başlandı. Hasta yatışlarının 1., 5. ve 7. günlerinde, prealbümin, albümin, CRP , IL-6, IL-10, APACHE II skorları ve mortalite oranları değerlendirildi. Bulgular: Grupların demografik özellikleri ve günlük kalori alımları arasında fark bulunmadı. SE grubunda, prealbümin değerlerinde azalma saptandı (p<0,05). CRP değerlendirildiğinde, İE ile İG gruplarında, SG grubuna göre azalma saptanmasına rağmen, SE grubuna göre fark olmadığı görüldü. Bununla birlikte SE grubunda ise 5.ve 7. günlerde artış gözlendi (p<0,05). IL-6 düzeyleri açısından, İE, SE ve İG gruplarının SG'ye göre 5 ve 7. günlerde anlamlı düzeyde azalma gösterdiği saptandı. IE grubunda ayrıca, 7. günde İG ve ...

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Early enteral nutrition is associated with reduced in-hospital mortality from sepsis in patients with sarcopenia

Cited by 23 publications

References 24 publications

Meeting nutritional targets of critically ill patients by combined enteral and parenteral nutrition: review and rationale for the EFFORTcombo trial

Meeting nutritional targets of critically ill patients by combined enteral and parenteral nutrition: review and rationale for the EFFORTcombo trial

Significant Published Articles for Pharmacy Nutrition Support Practice in 2018

The Effect of Early Enteral Immunonutrition to Inflammatory Response for Intensive Care Patients

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