Early low-energy versus high-energy enteral nutrition support in patients with traumatic intracerebral haemorrhage: protocol for a randomised controlled trial

Shen, Yanfei; Cheng, Xuping; Ying, Manzhen; Zhang, Weimin; Jiang, Xuandong; Du, Kailei

doi:10.1136/bmjopen-2017-019199

Cited by 5 publications

(6 citation statements)

References 23 publications

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“…6 However, numerous neurologically injured patients fail to achieve the target energy intake because of delayed gastric emptying and decreased tone of the lower esophageal sphincter. 2 In this regard, the results of 2 cluster, randomized controlled trials indicated no reduction in mortality in the patients receiving higher EN compared to the group receiving routine care. 7 On the other hand, some clinical studies have demonstrated that energy restriction may be beneficial, since it affects the longevity biomarkers, insulin sensitivity, metabolic inflammation, and oxidative stress.…”

Section: Introductionmentioning

confidence: 98%

“…The brain is a major, complex body organ, and its injury could largely affect the quality of life and impose an economic burden because of the associated healthcare issues. 1,2 In neurocritical care units, nutrition support is of utmost importance, since a critical neurologic insult may be followed by hypermetabolic and hypercatabolic responses. 3 According to Seule et al, early enteral nutrition (EN) is associated with clinical benefits, such as improved hypercatabolic state, muscle-mass loss, and infections.…”

Section: Introductionmentioning

confidence: 99%

“…10 The discrepancy in the findings may be due to the heterogeneity of critically ill patients. 2 Since no prior reports have been published on the appropriate dose of energy intake for the patients admitted to neurocritical care units, the present study aimed to determine whether the dose of energy intake could influence the clinical outcomes in critically ill patients admitted to the intensive care unit (ICU).…”

Section: Introductionmentioning

confidence: 99%

“…The recommended energy intake could decrease malnutrition in patients, which is associated with impaired immune function and increased morbidity and mortality 6 . However, numerous neurologically injured patients fail to achieve the target energy intake because of delayed gastric emptying and decreased tone of the lower esophageal sphincter 2 . In this regard, the results of 2 cluster, randomized controlled trials indicated no reduction in mortality in the patients receiving higher EN compared to the group receiving routine care 7 …”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, low‐energy intake has been shown to diminish the mechanical ventilation duration (MVD) and improve overall mortality 10 . The discrepancy in the findings may be due to the heterogeneity of critically ill patients 2 …”

Section: Introductionmentioning

confidence: 99%

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Randomized Controlled Trial of Comparative Hypocaloric vs Full‐Energy Enteral Feeding During the First Week of Hospitalization in Neurosurgical Patients at the Intensive Care Unit

Mousavian

Pasdar

Ranjbar

et al. 2020

J Parenter Enteral Nutr

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Background: Nutrition support plays a pivotal role in improving the clinical outcomes of the patients admitted to the intensive care unit (ICU). However, there are controversies regarding the optimal amount of energy for the reduction of morbidity and mortality in neurosurgical patients at the ICU. Methods: This randomized clinical trial was conducted on 560 patients who were admitted to trauma, stroke, and neurosurgery ICUs, and 68 patients were enrolled based on the inclusion criteria. In total, data of 58 patients were analyzed. In the full-energy group, enteral feeding started at 75% of their daily energy expenditure and gradually increased to 90%-100%. In the hypocaloric group, enteral feeding started with 30% of the daily energy expenditure and reached 75% within 7 days of the intervention. Results: No significant differences were observed in the baseline characteristics of the patients in the hypocaloric and full-energy groups. The incidence of severe gastrointestinal intolerance was relatively high in the full-energy group (P < .001). Duration of mechanical ventilation and length of hospital stay were lower in the hypocaloric group compared with the full-energy group (P = .014 and P = .046, respectively). However, no significant differences were denoted in the length of ICU admission (P = .163), 28-day mortality (P = .640), and pneumonia (P = .162) between the study groups. Conclusions: In the neurocritical care unit, hypocaloric enteral feeding was associated with lower gastrointestinal intolerance, as well as reduced duration of ventilator dependence and length of hospital stay.

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Randomized Controlled Trial of Comparative Hypocaloric vs Full‐Energy Enteral Feeding During the First Week of Hospitalization in Neurosurgical Patients at the Intensive Care Unit

Mousavian

Pasdar

Ranjbar

et al. 2020

J Parenter Enteral Nutr

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Water Browning Controls Adaptation and Associated Trade-Offs in Phytoplankton Stressed by Chemical Pollution

Rizzuto

Thrane

Baho

et al. 2020

Environ. Sci. Technol.

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Acquisition of tolerance to an environmental stressor can cause trade-offs and result in organisms with slower growth. While this is theoretically grounded, assessments of the nature of this tradeoff, environmental controls, and implications for organisms' fitness, are insufficient. Here, we report the effects of water browning on the toxic responses, tolerance acquisition and associated trade-offs in a population of microalgae exposed to sub-lethal concentrations of organic micropollutants over multiple generations. Our results show that dissolved organic matter (DOM) reduces toxic responses and modulates tolerance acquisition by the algae, possibly by complexing micropollutants. Microalgae that acquire tolerance allocate resources in fitness at the cost of a reduced cell size. They yield higher productivity than non-adapted ones when grown in presence of micropollutants, but lower in their absence. This growth efficiency trade-off is positive, indicating that -despite the costs of adaptation -tolerant organisms will have higher productivity and fitness in recurrently stressed environments.

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Optimal Nutritional Factors Influencing the Duration of Mechanical Ventilation Among Adult Patients with Critical Illnesses in an Intensive Care Unit

Koontalay¹,

Suksatan²,

Sadang³

et al. 2021

Preprint

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Objective: This study aims to identify the impact of nutritional factors on mechanical ventilation duration for critical patients. Patients and Methods: The current study was a single-center, prospective observational design which enrolled one-hundred critically ill patients who were admitted to an intensive care unit (ICU). It demonstrates purposive sampling and also performs the descriptive nutritional factors influencing the mechanical ventilation duration. Daily calories target requirement scale (DCRS), subjective global assessment form (SGA), dyspnea assessment form, and APACHE II have been used as methods in the study along with time to initial enteral nutrition (EN) after 24-hour admission and daily calories target requirement over 7 days to assess patients. Data is analyzed using the multiple regressions. Results: As a result, nutritional status monitoring, time to initial EN, calories and target requirements are statistically positive significance associated with the mechanical ventilation duration respectively (R = 0.54, R = 0.30, R= 0.40, p < 0.05). However, age, illness severity, and dyspnea scales are not associated with the mechanical ventilation duration (p> 0.05). Therefore, the nutritional status, malnutrition scores and calorie target requirements can be used to significantly predict the mechanical ventilation duration. The predictive power is 58 and 28.0% of variance. The most proper influencer to predict the mechanical ventilation duration is nutritional status or malnutrition scores. Conclusion: The research findings show that the nutritional status, time to initial EN, and calorie target requirement within 7 days of admission are associated with the mechanical ventilation duration in the critical patients. Therefore, it can be used to develop guidelines reducing the mechanical ventilation duration and to promote the ventilator halting for critical patients.

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Early low-energy versus high-energy enteral nutrition support in patients with traumatic intracerebral haemorrhage: protocol for a randomised controlled trial

Cited by 5 publications

References 23 publications

Randomized Controlled Trial of Comparative Hypocaloric vs Full‐Energy Enteral Feeding During the First Week of Hospitalization in Neurosurgical Patients at the Intensive Care Unit

Randomized Controlled Trial of Comparative Hypocaloric vs Full‐Energy Enteral Feeding During the First Week of Hospitalization in Neurosurgical Patients at the Intensive Care Unit

Water Browning Controls Adaptation and Associated Trade-Offs in Phytoplankton Stressed by Chemical Pollution

Optimal Nutritional Factors Influencing the Duration of Mechanical Ventilation Among Adult Patients with Critical Illnesses in an Intensive Care Unit

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