Nutritional therapy in patients with sepsis: is less really more?

Koning, M.W.A. de; Zanten, Florianne Johanna Louise van; Zanten, Arthur R.H. van

doi:10.1186/s13054-020-02949-9

Cited by 3 publications

(2 citation statements)

References 5 publications

(9 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Van Niekerk et al [ 32 ] suggested that less nutrition supply may be beneficial during sepsis. However, the PROCASEPT study indicated that low protein intake or caloric restriction may not be of benefit in septic patients[ 33 , 34 ], and overfeeding during days 4-7 was related to a lower 6-mo mortality, compared with low caloric intake[ 34 ]. Due to the lack of direct or indirect calorimetric system of energy metabolism, we used the most commonly predictive equations to estimate the goal energy requirement of patients (20-25 kcal/kg per day) according to ASPEN and ESPEN guidelines[ 8 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of permissive hypocaloric vs standard enteral feeding on gastrointestinal function and outcomes in sepsis

Sun¹,

Nie²,

Chen³

et al. 2021

WJG

View full text Add to dashboard Cite

BACKGROUND Intestinal mucosal barrier injury and gastrointestinal dysfunction are important causes of sepsis. However, few studies have investigated the effects of enteral underfeeding on gastrointestinal function in sepsis. Moreover, no consensus on goal enteral caloric intake has been reached in sepsis. AIM To investigate the effects of different goal caloric requirements of enteral nutrition on the gastrointestinal function and outcomes in the acute phase of sepsis. METHODS Patients were randomly assigned to receive 30% (defined as group A), 60% (group B), or 100% (group C) of goal caloric requirements of enteral nutrition in this prospective pilot clinical trial. The acute gastrointestinal injury (AGI) grades, incidence of feeding intolerance (FI), daily caloric intake, nutritional and inflammatory markers, and biomarkers of mucosal barrier function were collected during the first 7 d of enteral feeding. The clinical severity and outcome variables were also recorded. RESULTS A total of 54 septic patients were enrolled. The days to goal calorie of group C (2.55 ± 0.82) were significantly longer than those of group A (3.50 ± 1.51; P = 0.046) or B (4.85 ± 1.68; P < 0.001). The FI incidence of group C (16.5%) was higher than that of group A (5.0%) or B (8.7%) ( P = 0.009). No difference in the incidence of FI symptoms was found between groups A and B. The serum levels of barrier function biomarkers of group B were significantly lower than those of group A ( P < 0.05) on the 7th day of feeding. The prealbumin and IL-6 levels of group A were lower than those of group B ( P < 0.05) on the 7 th day of feeding. No significant differences in the clinical outcome variables or 28-d mortality were found among the three groups. CONCLUSION Early moderate enteral underfeeding (60% of goal requirements) could improve the intestinal barrier function and nutritional and inflammatory status without increasing the incidence of FI symptoms in sepsis. However, further large-scale prospective clinical trials and animal studies are required to test our findings. Moreover, the effects of different protein intake on gastrointestinal function and outcomes should also be investigated in future work.

show abstract

Section: Discussionmentioning

confidence: 99%

Effects of permissive hypocaloric vs standard enteral feeding on gastrointestinal function and outcomes in sepsis

Sun¹,

Nie²,

Chen³

et al. 2021

WJG

View full text Add to dashboard Cite

show abstract

“…Os tratamentos direcionados à sepse objetivam eliminar o foco infeccioso e a resposta imune desregulada, com o auxílio da antibioticoterapia, uso de esteroides, entre outros fármacos. No entanto, o feedback do metabolismo durante a sepse reflete de maneira negativa sobre o estado nutricional do indivíduo acometido, uma vez que o processo inflamatório indispõe o sistema gastrointestinal (KONING et al, 2020;WAELE et al, 2020;TAEB et al, 2017). Uma das características mais relevantes da sepse, é seu quadro catabólico agudo que desencadeia uma mobilização dos estoques de glicogênio, proteínas e lipídeos para estimular a produção de glicose, resultando em um quadro notável de hiperglicemia.…”

Section: Terapia Nutricionalunclassified

Terapia Nutricional Na Sepse: Uma Revisão Integrativa

Matos

Sousa

Oliveira

et al. 2022

BJCR

View full text Add to dashboard Cite

INTRODUÇÃO: a sepse é definida quando há associação entre a síndrome de resposta inflamatória sistêmica (SIRS) e a infecção, seu diagnóstico precoce é de suma importância para instituir as estratégias terapêuticas mais adequadas e reduzir risco de mortalidade. OBJETIVO: abordar o tratamento dietoterápico em pacientes com sepse. MÉTODOS: através de uma revisão bibliográfica feita nas bases de dados Google Acadêmico, PubMed e Scielo. RESULTADOS: a presente pesquisa indicou que a terapia nutricional na sepse tem como finalidade minimizar a inanição, fornecer a quantidade de energia adequada para suprir as demandas de macro e micronutrientes, além atenuar a resposta catabólica. CONCLUSÃO: diante do exposto, entende-se que por se tratar de uma doença de alta morbimortalidade é imprescindível que os profissionais da equipe multidisciplinar dominem todos os processos etiológicos, fisiopatológicos e terapêuticos acerca dessa patologia, somente dessa forma é possível minimizar riscos e traçar a melhor estratégia de tratamento para cada paciente.

show abstract