What the clinician needs to know about medical nutrition therapy in critically ill patients in 2023: A narrative review

Dresen, Ellen; Notz, Quirin; Menger, Johannes; Homayr, Anna Lulu; Lindner, Matthias; Radke, David I; Stoppe, Christian; Elke, Gunnar

doi:10.1002/ncp.10984

Cited by 9 publications

(2 citation statements)

References 122 publications

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“…An exceptional number of high-quality large-scale nutrition RCTs in the field of critical care medicine have been published in the last 12 months evaluating key nutrition aspects, such as the role of different micronutrients, high protein, and moderate vs low macronutrient intake, which have been reviewed in detail elsewhere. 5 Table 1 presents an overview of those RCTs that were identified to be presented at the ASPEN meeting. Each presented study will be highlighted here.…”

Section: Year In Review: Critical Care Medicinementioning

confidence: 99%

Highlights in the clinical nutrition literature: A critical appraisal of current research

Stoppe,

Elke,

Silvstre

et al. 2024

J Parenter Enteral Nutr

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Within the American Society for Parenteral and Enteral Nutrition (ASPEN), the Physician Engagement Committee (PEC) was created in 2017 by the ASPEN Board of Directors with the goal of growing the physician community both nationally and internationally. The PEC meets each month throughout the year to develop educational and research initiatives. In 2022, the PEC began an initiative to systematically review and evaluate practice‐changing literature annually with the overall aim to highlight these studies at the annual ASPEN conferences and to critically discuss the potential clinical implications. The objective of the held meeting session was to present identified key papers in the fields of critical care medicine, gastroenterology and hepatology, and adult internal medicine that were published in 2022, which would complement the knowledge of the pathogenesis, diagnosis, and management of nutrition topics as well as to identify areas of future research. Overall, several large‐scale randomized controlled studies were identified in each of these sections, with practice‐changing major results. This manuscript summarizes the information that was presented and the discussions that followed.

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Section: Year In Review: Critical Care Medicinementioning

confidence: 99%

Highlights in the clinical nutrition literature: A critical appraisal of current research

Stoppe,

Elke,

Silvstre

et al. 2024

J Parenter Enteral Nutr

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“…During this critical phase, nutritional status before the illness and the nutritional support received in the ICU can impact ICU mortality. 1 , 2 …”

Section: Introductionmentioning

confidence: 99%

Nutritional Prescription in ICU Patients: Does it Matter?

Havaldar,

Selvam

2024

Indian Journal of Critical Care Medicine

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A bstract Background The nutritional status of the patients before critical illness and nutrition support given during the critical illness play an important role in the recovery. We aimed to evaluate the nutritional prescription and its effect on ICU mortality. Materials and methods This was a prospective observational study conducted after institutional ethical committee approval (IEC 94/2018, CTRI/2018/06/014625) in a case-mixed (medical and surgical) ICU. Patients admitted to the ICU were enrolled within 24 hours of admission. The amount of calories and proteins prescribed and received by the patients was collected for 7 days. The primary outcome was ICU mortality. Results A total of 100 patients were included. The mean age was 48.63 (16.25) years, and 62% were males. The acute physiology and chronic health evaluation (APACHE II), sequential organ failure assessment (SOFA), and modified Nutric (mNUTRIC) scores were comparable between the two groups. The ICU mortality was 30%. The calorie and protein deficits were comparable between survivors and non-survivors. Among the secondary outcomes, a significant time effect ( p = 0.013) and interaction effect ( p = 0.004) were noted for maximum glucose levels. The glucose variability calculated by coefficient of variation (CV) was significantly higher in non-survivors than survivors ( p = 0.031). Conclusion The calorie and protein deficits did not affect ICU mortality. The maximum glucose variability and CV were significant parameters associated with ICU mortality. How to cite this article Havaldar AA, Selvam S. Nutritional Prescription in ICU Patients: Does it Matter? Indian J Crit Care Med 2024;28(7):657–661.

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New randomized controlled trials on micronutrients in critical care nutrition: A narrative review

Halim,

Huang,

Lee

et al. 2024

Nut in Clin Prac

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There has been increasing interest in the role of micronutrient supplementation in critical care. This narrative review summarizes the recent studies on micronutrients in critically ill patients. We searched two databases for primary randomized controlled trials that investigated the effects of micronutrient supplementation in patients with critical illness published from January 2021 to August 2023. Personal files, reference lists of included studies, and previous reviews were also screened. Twelve studies reported on vitamin C, four studies on vitamin D, three studies on thiamin, two studies on multivitamins, and one study on cobalamin. The therapeutic effects of vitamin C appear mixed, although vitamin C monotherapy appears more promising than vitamin C combination therapy. Intramuscular administration of vitamin D appeared to lower mortality, mechanical ventilation duration, and intensive care unit stay, whereas enteral administration showed limited clinical benefits. Intravenous thiamin was not associated with improved outcomes in patients with septic shock or hypophosphatemia. Preliminary evidence suggests reduced vasopressor dose with cobalamin. Decreased disease severity and hospital stay in patients with COVID‐19 with vitamins A–E requires further investigation, whereas providing solely B‐group vitamins did not demonstrate therapeutic effects. It is currently premature to endorse the provision of high‐dose micronutrients in critical illness to improve clinical outcomes. This review may help to inform the design of future trials that will help better elucidate the optimal dosage and form of micronutrients, methods of administration, and subgroups of patients with critical illness who may most benefit.

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What the clinician needs to know about medical nutrition therapy in critically ill patients in 2023: A narrative review

Cited by 9 publications

References 122 publications

Highlights in the clinical nutrition literature: A critical appraisal of current research

Highlights in the clinical nutrition literature: A critical appraisal of current research

Nutritional Prescription in ICU Patients: Does it Matter?

New randomized controlled trials on micronutrients in critical care nutrition: A narrative review

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