Feeding Practices of Severely Ill Intensive Care Unit Patients: An Evaluation of Energy Sources and Clinical Outcomes

Hise, Mary; Halterman, Kelly; Gajewski, Byron J.; Parkhurst, Melissa; Moncure, Michael; Brown, John C.

doi:10.1016/j.jada.2006.12.012

Cited by 48 publications

(31 citation statements)

References 19 publications

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“…Mandel and Worthley [8] first reported the inadequacy of enteral nutritional intake in patients on general wards and intensive care units (ICUs) more than 25 years ago. Nonetheless, underfeeding continues to be a frequent problem in enterally fed critically ill patients [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Why patients in critical care do not receive adequate enteral nutrition? A review of the literature

Kim

Stotts

Froelicher

et al. 2012

Journal of Critical Care

102

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Section: Introductionmentioning

confidence: 99%

Why patients in critical care do not receive adequate enteral nutrition? A review of the literature

Kim

Stotts

Froelicher

et al. 2012

Journal of Critical Care

102

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“…(Figure 2 should give the protein 1.5 -2 g/kg/day and account for 24-32 percent of the total received energy (8). Although the surgical ICU patients significantly received lipid-based sedation (or propofol) compared to the medical ward (18), it was the relatively small amount, and we did not include in the total energy calculation. On the total calories intake (Figure 3), the average of caloric intake in this study was 20 kcal/kg/day when the energy balance was nearly zero.…”

Section: Discussionmentioning

confidence: 99%

Characters of Nutrition Status and Energy-delivery Patterns of the University-based Surgical Intensive Care Units in Thailand (Multi-center Thai-Sicu Study)

Auiwattanakul¹,

Chittawatanarat²,

Chaiwat³

et al. 2018

Med Arch

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Aim: The authors aimed to describe nutrition status and energy-delivery characters in multi-center THAI-SICU study. Material and Methods: Eligible patients admitted in SICU were 1,686 after excluding 563 of 2,249 participants owing to very short stay or non-alive within 24 hours after admission and missing data. The study was a posthoc analysis and multicenter descriptive design. The analytic methods described categorical data in percentage and the continuous data in the median with interquartile range. Variables divided into baseline characteristics and nutrition data before SICU admission, and the pattern of energy delivery in SICU. Statistical significance accepted as a p-value less than 0.05. Results: The average age was 64 (52-76) years with 57% male. The median of serum albumin level at admission (interquartile range, IQR) was 2.8 (2.2-3.4). There was 46 -47 percent of nutrition risk patient.Less than 10 percent of the patient had enteral (EN), parenteral (PN) or their combination before admission. History of weight loss and appetite loss was 27-31 percent. However, seventy percent of the patient could not define the duration of the symptom. EN was initiated early, but the tendency of full feeding was 7-10 days. At that period, supplemental PN was added around 30 percent of total calories. The composition of PN was quite low in these study which contains only 15-16 percent of total calories. The average energy delivery was 20 kcal/kg/day (the recommendation is 25-30 kcal/kg/day). Conclusion: The patient's nutrition status before SICU admission was at risk of 46-47% and weight loss and appetite loss might unreliable in ICU setting. EN is started early with gradually increase up to 7-10 days. The average total calories requirement is lower than a recommendation.

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“…Hise et al 94 made note that prior studies of nutritional intake neglect to quantify incidental kcal received through intravenous dextrose and lipid-based sedatives (eg, propofol). This group performed a prospective cohort study of 77 critically ill patients (in ICU Ն 5 d), accounting for calories received outside of nutritional therapy.…”

Section: Evidence Base For Nutrition Support In CCImentioning

confidence: 99%

“…91,94 However, a possible bias in these studies is that more severely ill patients are less likely to tolerate or receive uninterrupted EN and more likely to require a longer ICU course with more complications. 91 In sum, the above data are not convincing with respect to optimal nutrition support in the CCI patient.…”

Section: Evidence Base For Nutrition Support In CCImentioning

confidence: 99%

Metabolic and Nutrition Support in the Chronic Critical Illness Syndrome

Schulman

Mechanick²

2012

Respir Care

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Technological innovations in the ICU have led to artificially prolonged life, with an associated cost. Chronic critical illness (CCI) occurs in patients with prolonged mechanical ventilation and allostatic overload, and is associated with a discrete and consistent metabolic syndrome. Metabolic interventions are extrapolated from clinical critical care research, scientific theory, and years of CCI patient care experience. Intensive metabolic support (IMS) is a multi-targeted approach consisting of tight glycemic control with intensive insulin therapy, early and adequate nutrition therapy, nutritional pharmacology, management of metabolic bone disease, and meticulous attention to other endocrine/metabolic derangements. Ideally, IMS should be under the supervision of a metabolic support consultative team. Further research specifically focused on the CCI population is needed to validate this current approach.

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Feeding Practices of Severely Ill Intensive Care Unit Patients: An Evaluation of Energy Sources and Clinical Outcomes

Cited by 48 publications

References 19 publications

Why patients in critical care do not receive adequate enteral nutrition? A review of the literature

Why patients in critical care do not receive adequate enteral nutrition? A review of the literature

Characters of Nutrition Status and Energy-delivery Patterns of the University-based Surgical Intensive Care Units in Thailand (Multi-center Thai-Sicu Study)

Metabolic and Nutrition Support in the Chronic Critical Illness Syndrome

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