Supplemental parenteral nutrition improves immunity with unchanged carbohydrate and protein metabolism in critically ill patients: The SPN2 randomized tracer study

Berger, Mette M.; Pantet, Olivier; Jacquelin-Ravel, N.; Charrière, M.; Schmidt, Sabine; Becce, Fabio; Audran, R; Spertini, François; Tappy, Luc; Pichard, Claude

doi:10.1016/j.clnu.2018.10.023

Cited by 66 publications

(99 citation statements)

References 24 publications

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“…In the intervention group, some patients did not receive SPN when EN was sufficient [ 16 ]. Our meta-analysis included studies where PN was initiated along with EN within 48–72 h of hospital admission [ 23 , 25 , 27 ], while in two studies, PN was initiated on day 4 [ 24 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…The small number of studies ( n = 5) is a limitation of the current meta-analysis. This was because only a few RCTs have compared the effects of SPN + EN to EN alone [ 23 , 24 , 25 , 26 , 27 , 33 , 34 ]. Therefore, more studies are needed to confirm the results of the current systematic review.…”

Section: Discussionmentioning

confidence: 99%

“…Energy targets in the included studies ranged from to 20–30 kcal/kg using either the actual, ideal, or adjusted body weight [ 23 , 25 , 26 , 27 ]. The energy target was validated by indirect calorimetry in only one study [ 24 ]. Although the target energy intake seems similar between studies, it was not individualized based on each patient’s needs.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Supplemental Parenteral Nutrition Versus Enteral Nutrition Alone on Clinical Outcomes in Critically Ill Adult Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Alsharif

Aljuraiban

et al. 2020

Nutrients

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Enteral nutrition (EN) is considered the first feeding route for critically ill patients. However, adverse effects such as gastrointestinal complications limit its optimal provision, leading to inadequate energy and protein intake. We compared the clinical outcomes of supplemental parenteral nutrition added to EN (SPN + EN) and EN alone in critically ill adults. Electronic databases restricted to full-text randomized controlled trials available in the English language and published from January 1990 to January 2019 were searched. The risk of bias was evaluated using the Jadad scale, and the meta-analysis was conducted using the MedCalc software. A total of five studies were eligible for inclusion in the systematic review and meta-analysis. Compared to EN alone, SPN + EN decreased the risk of nosocomial infections (relative risk (RR) = 0.733, p = 0.032) and intensive care unit (ICU) mortality (RR = 0.569, p = 0.030). No significant differences were observed between SPN + EN and EN in the length of hospital stay, hospital mortality, length of ICU stay, and duration of mechanical ventilation. In conclusion, when enteral feeding fails to fulfill the energy requirements in critically ill adult patients, SPN may be beneficial as it helps in decreasing nosocomial infections and ICU mortality, in addition to increasing energy and protein intakes with no negative effects on other clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effect of Supplemental Parenteral Nutrition Versus Enteral Nutrition Alone on Clinical Outcomes in Critically Ill Adult Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Alsharif

Aljuraiban

et al. 2020

Nutrients

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“…Here is a paradigm that adequate proteins especially important for critically ill patients. Adequate protein delivery with total energy could reduce PICS; however, a number of studies have reported that protein delivery alone does not reduce PICS . As muscle protein synthesis is maximized with appropriate exercise in healthy individuals, not only nutrition therapy alone but also appropriate exercise and rehabilitation together with adequate nutrition are also necessary in critically ill patients (Fig.…”

Section: Introductionmentioning

confidence: 99%

Post‐intensive care syndrome: its pathophysiology, prevention, and future directions

Inoue

Hatakeyama

Kondo

et al. 2019

Acute Medicine & Surgery

376

365

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Expanding elderly populations are a major social challenge in advanced countries worldwide and have led to a rapid increase in the number of elderly patients in intensive care units (ICUs). Innovative advances in medical technology have enabled lifesaving of patients in ICUs, but there remain various problems to improve their long‐term prognoses. Post‐intensive care syndrome (PICS) refers to physical, cognition, and mental impairments that occur during ICU stay, after ICU discharge or hospital discharge, as well as the long‐term prognosis of ICU patients. Its concept also applies to pediatric patients (PICS‐p) and the mental status of their family (PICS‐F). Intensive care unit‐acquired weakness, a syndrome characterized by acute symmetrical limb muscle weakness after ICU admission, belongs to physical impairments in three domains of PICS. Prevention of PICS requires performance of the ABCDEFGH bundle, which incorporates the prevention of delirium, early rehabilitation, family intervention, and follow‐up from the time of ICU admission to the time of discharge. Diary, nutrition, nursing care, and environmental management for healing are also important in the prevention of PICS. This review outlines the pathophysiology, prevention, and future directions of PICS.

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“…99,100 Multiple studies have documented the loss of micronutrients, such as copper, zinc, selenium, folic acid, magnesium, vitamin C, vitamin E, thiamin, chromium, and iron. [98][99][100][101][102] In one study of patients undergoing CVVHD, different dialysis doses did not result in clinically relevant losses of folic acid, vitamin B 12 , zinc, magnesium, and inorganic phosphate. 100 This study specifically involved CVVHD and not other types of CRRT, so this may not be generalizable across all CRRT modalities.…”

Section: Loss Of Vitamins and Micronutrients With Rrtmentioning

confidence: 99%

Acute Kidney Injury Incidence in Hospitalized Patients and Implications for Nutrition Support

et al. 2020

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Hospitalized adult patients suffer from high rates of acute kidney injury (AKI), which puts them at risk for multiple nutrition problems. The etiology and management strategy of AKI has major implications for the management of the hospitalized patient. The purpose of this review is to understand the incidence and management of AKI in hospitalized adult patients and review the challenges to providing adequate nutrition support.

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Supplemental parenteral nutrition improves immunity with unchanged carbohydrate and protein metabolism in critically ill patients: The SPN2 randomized tracer study

Cited by 66 publications

References 24 publications

Effect of Supplemental Parenteral Nutrition Versus Enteral Nutrition Alone on Clinical Outcomes in Critically Ill Adult Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Effect of Supplemental Parenteral Nutrition Versus Enteral Nutrition Alone on Clinical Outcomes in Critically Ill Adult Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Post‐intensive care syndrome: its pathophysiology, prevention, and future directions

Acute Kidney Injury Incidence in Hospitalized Patients and Implications for Nutrition Support

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