NutritionDay ICU: A 7 year worldwide prevalence study of nutrition practice in intensive care

Nutrition Therapy in Australia and New Zealand Intensive Care Units: An International Comparison Study

“…The sites in ANZ prescribed and delivered higher amounts of energy when compared with the international sites; however, the overall provision of energy and protein in both regions remained substantially less than the estimated requirements. The delivery of less than the recommended energy and protein during critical illness is a consistent observation regardless of region investigated and/or different survey data are used . Importantly, this establishes that the group randomized to receive routine care in TARGET, as identified in the pilot trial, represents standard practice within ANZ and internationally .…”

“…The delivery of less than the recommended energy and protein during critical illness is a consistent observation regardless of region investigated and/or different survey data are used. [10][11][12][13] Importantly, this establishes that the group randomized to receive routine care in TARGET, as identified in the pilot trial, represents standard practice within ANZ and internationally. 14 The following practice issues have previously been described as contributing to nutrition inadequacy in critical illness and may be contributing in this analysis: interruptions to EN (which were frequently observed in this study and a feature of nutrition therapy guidelines in ANZ ICUs), delayed initiation of nutrition, and gastrointestinal intolerance.…”

High‐Protein Hypocaloric Nutrition for Non‐Obese Critically Ill Patients

“…7,22,23,35 More recently it has become clear that EN has its own problem: it progresses too slowly to meet currently recommended protein and energy goals for most critically ill patients. 18,[36][37][38][39][40][41] The low protein-to-calorie ratio of most EN products makes the shortfall in protein provision especially serious. 21,[42][43][44] Recognizing that widely used EN regimens systematically fall short of their nutrition target, clinical investigators in several centers carried out large randomized clinical trials (RCTs) that compared standard (inadequate) EN with the same EN supplemented with PN that infused large amounts of dextrose but very little protein substrate.…”

How could we make nutrition in the intensive care unit simple?

“…According to the Nutrition Day ICU audit, there was no standard prescription in the 9,777 patients screened, (3) suggesting that many patients are either over- or underfed. Underfeeding has a negative impact on clinical outcomes while overfeeding results in an increase in blood sugar, VCO 2 production, length of ventilation as well as infections.…”