How does adequacy of caloric and protein intake associate with the clinical outcomes in critically ill adults of high nutritional risk?

Chan, KL; Au, Shek Yin; Ng, Wing-Yiu

doi:10.21037/jeccm-20-135

Cited by 2 publications

(2 citation statements)

References 21 publications

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“…In critically ill patients with high nutritional risk, indicated by an mNUTRIC score of ≥ 5, previous studies have demonstrated the bene ts of early caloric supplementation-providing higher energy and protein-in terms of reducing mortality and morbidity [19][20][21][22] . However, some studies have reported ndings that contradict these bene ts [23][24][25] . Consequently, it remains uncertain whether nutritional risk-based management, encompassing calorie and protein intake as well as formula composition, should be considered when implementing nutritional supplementation in critically ill patients, particularly those at high nutritional risk.…”

Section: Introductionmentioning

confidence: 99%

Comparative Efficacy of Peptide-Based versus Standard Polymeric Enteral Nutrition in ICU Patients at High Nutritional Risk: A Multicenter Randomized Controlled Trial

Bhurayanontachai,

Wacharasint,

Somboonviboon

et al. 2024

Preprint

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Introduction: Within intensive care units (ICU), the administration of peptide-based formulas (PBF) may confer nutritional advantages for critically ill patients identified with heightened nutritional risk. This investigation aimed to ascertain the efficacy of PBF in comparison to standard polymeric formulas (SPF) among this patient cohort. Methods A double-blind, randomized controlled trial was conducted across three ICUs, encompassing 63 adult patients characterized by elevated modified Nutrition Risk in Critically Ill (mNUTRIC) scores. Enrollment occurred promptly subsequent to ICU admission, with participants allocated to receive either PBF or SPF. Primary outcome was the duration to achieve caloric targets. Secondary outcomes involved the evaluation of mean daily gastric residual volume, mechanical ventilation period, infection rates within the ICU, length of hospitalization, mortality rates, nutritional status and inflammatory markers, specifically serum albumin and interleukin-6 levels. Results Patients in the PBF group reached their caloric targets more expeditiously compared to the SPF group (2.06 ± 0.43 days versus 2.39 ± 0.79 days; p = 0.03). No significant differences were discernible between the groups regarding gastric residual volume, duration of mechanical ventilation, ICU length of stay, mortality, or infection rates. Both cohorts exhibited minimal adverse effects and were devoid of any instances of abdominal distension. While not reaching statistical significance, the observed trends in albumin and interleukin-6 levels suggest a potential advantage of PBF utilization. Conclusions The implementation of PBF enabled swifter attainment of caloric goals in ICU patients at high nutritional risk without adversely impacting other clinical parameters. Given its favorable tolerance profile and potential immunomodulatory properties, PBF may be considered a valuable nutritional intervention in this setting. Trial Registration Thai Clinical Trials Registry TCTR20220221006. Registered 21 February 2022, https://www.thaiclinicaltrials.org/show/TCTR20220221006

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Section: Introductionmentioning

confidence: 99%

Comparative Efficacy of Peptide-Based versus Standard Polymeric Enteral Nutrition in ICU Patients at High Nutritional Risk: A Multicenter Randomized Controlled Trial

Bhurayanontachai,

Wacharasint,

Somboonviboon

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…In critically ill patients with an mNUTRIC score of ≥ 5, early caloric supplementation has been linked to reduced mortality and morbidity by providing higher energy and protein, and by facilitating the rapid achievement of caloric goals 19 – 22 . However, some studies have reported findings that contradict these benefits 23 – 25 . Consequently, it remains uncertain whether nutritional risk-based management, encompassing calorie and protein intake as well as formula composition, should be considered when implementing nutritional supplementation in critically ill patients, particularly those at high nutritional risk.…”

Section: Introductionmentioning

confidence: 99%

Comparative efficacy of peptide-based versus standard polymeric enteral nutrition in ICU patients at high nutritional risk: a multicenter randomized controlled trial

Bhurayanontachai,

Wacharasint,

Somboonviboon

et al. 2024

Sci Rep

View full text Add to dashboard Cite

Within intensive care units (ICU), the administration of peptide-based formulas (PBF) may confer nutritional advantages for critically ill patients identified with heightened nutritional risk. This investigation aimed to ascertain the efficacy of PBF in comparison to standard polymeric formulas (SPF) among this patient cohort. A double-blind, randomized controlled trial was conducted across three ICUs, encompassing 63 adult patients characterized by elevated modified Nutrition Risk in Critically Ill (mNUTRIC) scores. Enrollment occurred promptly subsequent to ICU admission, with participants allocated to receive either PBF or SPF. Primary outcome was the duration to achieve caloric targets. Secondary outcomes involved the evaluation of mean daily gastric residual volume, mechanical ventilation period, infection rates within the ICU, length of hospitalization, mortality rates, nutritional status and inflammatory markers, specifically serum albumin and interleukin-6 levels. Patients in the PBF group reached their caloric targets more expeditiously compared to the SPF group (2.06 ± 0.43 days versus 2.39 ± 0.79 days; p = 0.03). No significant differences were discernible between the groups regarding gastric residual volume, duration of mechanical ventilation, ICU length of stay, mortality, or infection rates. Both cohorts exhibited minimal adverse effects and were devoid of any instances of abdominal distension. While not reaching statistical significance, the observed trends in albumin and interleukin-6 levels suggest a potential advantage of PBF utilization. The implementation of PBF enabled swifter attainment of caloric goals in ICU patients at high nutritional risk without adversely impacting other clinical parameters. Given its favorable tolerance profile and potential immunomodulatory properties, PBF may be considered a valuable nutritional intervention in this setting.Thai Clinical Trials Registry TCTR20220221006. Registered 21 February 2022, https://www.thaiclinicaltrials.org/show/TCTR20220221006.

show abstract

How does adequacy of caloric and protein intake associate with the clinical outcomes in critically ill adults of high nutritional risk?

Cited by 2 publications

References 21 publications

Comparative Efficacy of Peptide-Based versus Standard Polymeric Enteral Nutrition in ICU Patients at High Nutritional Risk: A Multicenter Randomized Controlled Trial

Comparative Efficacy of Peptide-Based versus Standard Polymeric Enteral Nutrition in ICU Patients at High Nutritional Risk: A Multicenter Randomized Controlled Trial

Comparative efficacy of peptide-based versus standard polymeric enteral nutrition in ICU patients at high nutritional risk: a multicenter randomized controlled trial

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