Meeting nutritional targets of critically ill patients by combined enteral and parenteral nutrition: review and rationale for the EFFORTcombo trial
| Autor: | Aileen Hill, Simone Lindau, Ulrich Suchner, Daren K. Heyland, Reto Stocker, Patrick Meybohm, Kai C. Clasen, Stefan J. Schaller, Danielle E. Bear, Christoph Haberthür, Zudin Puthucheary, Christian Stoppe, Gunnar Elke, Julia Ney, Christian von Loeffelholz, Thea Laurentius |
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| Rok vydání: | 2020 |
| Předmět: |
Parenteral Nutrition
medicine.medical_specialty Low protein Critical Illness Nutritional Status Medicine (miscellaneous) Enteral administration law.invention 03 medical and health sciences Enteral Nutrition 0302 clinical medicine Clinical Protocols Randomized controlled trial law Humans Medicine 030212 general & internal medicine Medical nutrition therapy Intensive care medicine Nutrition and Dietetics business.industry Critically ill Malnutrition Nutritional Requirements 030208 emergency & critical care medicine medicine.disease Combined Modality Therapy Intensive care unit Intensive Care Units Parenteral nutrition Dietary Proteins business |
| Zdroj: | Nutrition Research Reviews. 33:312-320 |
| ISSN: | 1475-2700 0954-4224 |
| Popis: | While medical nutrition therapy is an essential part of the care for critically ill patients, uncertainty exists about the right form, dosage, timing and route in relation to the phases of critical illness. As enteral nutrition (EN) is often withheld or interrupted during the intensive care unit (ICU) stay, combined EN and parenteral nutrition (PN) may represent an effective and safe option to achieve energy and protein goals as recommended by international guidelines. We hypothesise that critically ill patients at high nutritional risk may benefit from such a combined approach during their stay on the ICU. Therefore, we aim to test if an early combination of EN and high-protein PN (EN+PN) is effective in reaching energy and protein goals in patients at high nutritional risk, while avoiding overfeeding. This approach will be tested in the here-presented EFFORTcombo trial. Nutritionally high-risk ICU patients will be randomised to either high (≥2·2 g/kg per d) or low protein (≤1·2 g/kg per d). In the high protein group, the patients will receive EN+PN; in the low protein group, patients will be given EN alone. EN will be started in accordance with international guidelines in both groups. Efforts will be made to reach nutrition goals within 48–96 h. The efficacy of the proposed nutritional strategy will be tested as an innovative approach by functional outcomes at ICU and hospital discharge, as well as at a 6-month follow-up. |
| Databáze: | OpenAIRE |
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