Optimisation of energy provision with supplemental parenteral nutrition in critically ill patients: a randomised controlled clinical trial

Heidegger, Claudia Paula; Berger, Mette M.; Graf, S.; Zingg, Walter; Darmon, Patrice; Costanza, Michael C.; Thibault, Ronan; Pichard, Claude

doi:10.1016/s0140-6736(12)61351-8

Cited by 643 publications

(555 citation statements)

References 27 publications

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“…In a meta‐analysis of six RCTs extracted from the JSICM guidelines287 (Doig,323 Langouche,324 Heidegger,325 Casaer,326 Singer,327 and Bauer328), all six reported on mortality rate, four reported on bloodstream infection or respiratory infection, and five reported on urinary tract infection. The risk ratio for the impact of initiating parenteral nutrition within 1 week on mortality rate was 0.95 (95% CI: 0.81–1.11), the risk ratio for the impact on bloodstream infections was 1.22 (95% CI: 1.02–1.46), the risk ratio for the impact on respiratory infections was 1.07 (95% CI: 0.87–1.32), the risk ratio for the impact on urinary tract infections was 1.12 (95% CI: 0.84–1.49), and bloodstream infections significantly increased.…”

Section: Cq13: Nutritionmentioning

confidence: 99%

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The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Nishida

Ogura

Egi

et al. 2018

Acute Medicine & Surgery

157

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Background and PurposeThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016), a Japanese‐specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 in Japanese. An English‐language version of these guidelines was created based on the contents of the original Japanese‐language version.MethodsMembers of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ), and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two‐thirds (>66.6%) majority vote of each of the 19 committee members.ResultsA total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J‐SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation and its supporting evidence were also added to each recommendation statement. We conducted meta‐analyses for 29 CQs. Thirty seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for 5 CQs.ConclusionsBased on the evidence gathered, we were able to formulate Japanese‐specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non‐specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals.

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Section: Cq13: Nutritionmentioning

confidence: 99%

“…Evidence for this CQ was gathered from three essential papers 323, 325, 326. Differences in the nutritional management discussed in these three papers were examined, and the results were used to formulate the opinions serving as a basis for the recommendation offered by this CQ (expert consensus).…”

Section: Cq13: Nutritionmentioning

confidence: 99%

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Nishida

Ogura

Egi

et al. 2018

Acute Medicine & Surgery

157

View full text Add to dashboard Cite

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“…The difference is partially explained by the avoidance of a carbohydrate load which prompts higher insulin requirements and inhibits autophagy [11] and the overfeeding [6]. Another study has shown that progressive increase of enteral feeds delivery up to an energy target measured by indirect calorimetry, intermittently supplemented by PN, reduces the risk of nosocomial infections [12]. Epke et al [13] recently showed that an energy deficit during the first days in the ICU is associated with MRSA bloodstream infection in prolonged mechanically ventilated patients and suggested that limiting this energy deficit could optimize their prevention.…”

Section: Unrecognized Overfeeding Has Created Confusionmentioning

confidence: 99%

“…Only an observational trial [14] and three RCTs in ICU patients have based the energy target on indirect calorimetry [12,15,16]: all four trials reported clinical benefits. Petros et al [16] prospectively tested hypocaloric (50 % of measured energy needs) versus isocaloric (100 % of measured energy needs) feeding in 100 patients with an indication for nutritional support during the first 7 days after ICU admission.…”

Section: Adapting Intakes To Measured Expenditure: a Key To Successmentioning

confidence: 99%

Energy deficit is clinically relevant for critically ill patients: yes

2015

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“…Optimal nutritional care for intensive care unit (ICU) patients requires precise determination of the energy expenditure (EE) to avoid under-or over-feeding, both being deleterious [1,2]. Although indirect calorimetry (IC) is considered the reference method to determine EE, it is rarely available and suffers from some limitations in its feasibility.…”

Section: Introductionmentioning

confidence: 99%

Energy expenditure in mechanically ventilated patients: The weight of body weight!

et al. 2017

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Background & aims: Optimal nutritional care for intensive care unit (ICU) patients requires precise determination of energy expenditure (EE) to avoid deleterious under-or overfeeding. The reference method, indirect calorimetry (IC), is rarely accessible and inconstantly feasible. Various equations for predicting EE based on body weight (BW) are available. This study aims at determining the best prediction strategy unless IC is available. Methods: Mechanically ventilated patients staying !72 h in the ICU were included, except those with contraindications for IC measurements. IC and BW measurements were routinely performed. EE was predicted by the ESPEN formula and other predictive equations using BW (i.e. anamnestic (AN), measured (MES), adjusted for cumulated water balance (ADJ), calculated for a body mass index (BMI) of 22.5). Comparisons were made using Pearson correlation and Bland & Altman plots. Results: 85 patients (57 ± 19 y, 61 men, SAPS II 43 ± 16) were included. Correlations between IC and predicted EE using the ESPEN formula with different BW (BW AN , BW MES , BW ADJ , and BW BMI22.5 ) were 0.44, 0.40, 0.36, and 0.47, respectively. Bland & Altman plots showed wide and inconsistent variations. Predictive equations including body temperature and minute ventilation showed the best correlations, but when using various BWs, differences in predicted EE were observed. Conclusion: No EE predictive equation, regardless of the BW used, gives statistically identical results to IC. If IC cannot be performed, predictive equations including minute ventilation and body temperature should be preferred. BW has a significant impact on estimated EE and the use of measured BW MES or BW BMI 22.5 is associated with the best EE prediction. Clinical trial registration number on ClinicalTrial.gov: NCT02552446. Ethical committee number: CE-14-070.

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Optimisation of energy provision with supplemental parenteral nutrition in critically ill patients: a randomised controlled clinical trial

Cited by 643 publications

References 27 publications

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Energy deficit is clinically relevant for critically ill patients: yes

Energy expenditure in mechanically ventilated patients: The weight of body weight!

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