Effect of Enteral Versus Parenteral Nutrition on Outcome of Medical Patients Requiring Mechanical Ventilation

Altıntaş, Neriman Defne; Aydín, Kadriye; Türkoğlu, Melda; Abbasoğlu, Osman; Topeli, Arzu

doi:10.1177/0884533611405790

Cited by 48 publications

(34 citation statements)

References 35 publications

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“…The characteristics of the patients included in our study were not much different in age and gender distribution to those patients included in the Arab study of Arabi et al .,[13] (51 years, 68% male), who studied underfeeding in 480 ICU patients receiving parenteral nutrition; or the Turkish study of Altintas et al .,[12] (58 years, 54% male), who analyzed prognostic characteristics of a sample of 71 ICU patients that required mechanical ventilation. The German study of Schneider et al .,[24] that studied low-volume enteral supplementation in ICU, had somewhat younger patients (47 years, 57% male).…”

Section: Discussionmentioning

confidence: 93%

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Hyperproteic hypocaloric enteral nutrition in the critically ill patient: A randomized controlled clinical trial

Rugéles¹,

Rueda²,

Díaz³

et al. 2013

Indian Journal of Critical Care Medicine

103

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Introduction:Our aim was to evaluate the impact of hyperproteic hypocaloric enteral feeding on clinical outcomes in critically ill patients, particularly on severity of organic failure measured with the Sequential Organ Failure Assessment (SOFA).Materials and Methods:In a double blind clinical trial, 80 critically ill adult patients were randomized to hyperproteic hypocaloric or to isocaloric enteral nutrition; all patients completed follow-up of at least 4 days. Prescribed caloric intake was: Hyperproteic hypocaloric enteral nutrition (15 kcal/kg with 1.7 g/kg of protein) or isocaloric enteral nutrition (25 kcal/kg with 20% of the calories as protein). The main outcome was the differences in delta SOFA at 48 h. Secondary outcomes were intensive care unit (ICU) length of stay, days on ventilator, hyperglycemic events, and insulin requirements.Results:There were no differences in SOFA score at baseline (7.5 (standard deviation (SD) 2.9) vs 6.7 (SD 2.5) P = 0.17). The total amount of calories delivered was similarly low in both groups (12 kcal/kg in intervention group vs 14 kcal/kg in controls), but proteic delivery was significantly different (1.4 vs 0.76 g/kg, respectively P ≤ 0.0001). The intervention group showed an improvement in SOFA score at 48 h (delta SOFA 1.7 (SD 1.9) vs 0.7 (SD 2.8) P = 0.04) and less hyperglycemic episodes per day (1.0 (SD 1.3) vs 1.7 (SD 2.5) P = 0.017).Discussion:Enteral hyperproteic hypocaloric nutrition therapy could be associated with a decrease in multiple organ failure measured with SOFA score. We also found decreased hyperglycemia and a trend towards less mechanical ventilation days and ICU length of stay.

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Section: Discussionmentioning

confidence: 93%

“…Observational studies have shown deleterious clinical outcomes associated with overfeeding, especially with parenteral nutrition. [12] Likewise, the major disadvantage of enteral nutrition is the risk of underfeeding, which has also been associated with increased mortality[13] and higher risk of bacteremia. [14]…”

Section: Introductionmentioning

confidence: 99%

Hyperproteic hypocaloric enteral nutrition in the critically ill patient: A randomized controlled clinical trial

Rugéles¹,

Rueda²,

Díaz³

et al. 2013

Indian Journal of Critical Care Medicine

103

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“…More recently, a clinical trial did not fi nd any difference in the incidence of VAP in patients receiving enteral versus parenteral nutrition [ 38 ].…”

Section: Enteral Feedingmentioning

confidence: 98%

The Most Recent Strategies for VAP (Ventilator-Associated Pneumonia) Prevention

Chiumello

Coppola

Froio

2015

Practical Issues Updates in Anesthesia and Intensive Care

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“…12 These complications relate in particular to patients receiving total PN 15,50,51 and less frequently to patients receiving EN. 52 Hyperglycemia, liver dysfunction, infectious complications, prolonged mechanical ventilation, and increased mortality have all been associated with hypercaloric feeding. [53][54][55][56] The contribution of nonnutritional sources of energy such as propofol (1.1 kcal/mL and 0.1 g of fat/mL) and 5% dextrose (50 g of carbohydrate and 200 kcal/1000 mL) should be included as part of energy intake to avoid the adverse effects of overfeeding.…”

Section: Determining Energy and Protein Requirements Energy Requirementsmentioning

confidence: 99%

Nutrition Assessment of the Intensive Care Unit Patient

O’Hanlon

Dowsett

Smyth

2015

Topics in Clinical Nutrition

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Nutrition support in the intensive care unit can impact favorably on disease severity, development of complications, modulation of the immune response, and length of stay, resulting in improved outcomes (ASPEN [American Society for Parenteral and Enteral Nutrition] 2009 guideline), but determining an individual's precise nutritional requirements remains a clinical challenge. By understanding the impact of critical illness on nutrient requirements, the dietitian can estimate needs and provide nutrition support. Monitoring tolerance to individualized nutrition support helps avoid the negative consequences of under-and overfeeding. Evidence-based nutrition support guidelines and specifically tailored care plans play a significant role in optimizing nutritional management, thus improving patient outcomes and reducing health care costs.

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Effect of Enteral Versus Parenteral Nutrition on Outcome of Medical Patients Requiring Mechanical Ventilation

Cited by 48 publications

References 35 publications

Hyperproteic hypocaloric enteral nutrition in the critically ill patient: A randomized controlled clinical trial

Hyperproteic hypocaloric enteral nutrition in the critically ill patient: A randomized controlled clinical trial

The Most Recent Strategies for VAP (Ventilator-Associated Pneumonia) Prevention

Nutrition Assessment of the Intensive Care Unit Patient

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