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Parenteral nutrition and calorie delivery in the ICU: controversy, clarity, or call to action?

Publication ,  Journal Article
Wischmeyer, P
Published in: Curr Opin Crit Care
April 2012

PURPOSE OF REVIEW: This review will highlight recent data evaluating the role of parenteral nutrition and calorie delivery in the intensive care setting. Specific focus will be placed on recent trials of early and/or supplemental parenteral nutrition (SPN) and optimization of calorie delivery in ICU patients on the basis of nutrition risk and acuity of illness. The potential key role of protein delivery in outcome will also be discussed. RECENT FINDINGS: Recent randomized clinical trial (RCT) evidence reveals conflicting results around the use of SPN utilized to augment insufficient enteral nutrition. These trials had significant differences with regard to acuity of illness (mortality risk), method of calorie delivery, and protein intake. Recent observational trials reveal a patient's preillness nutrition status and adequacy of protein intake may be vital determinants of the effect of SPN and optimal calorie delivery on outcome. SUMMARY: The conflicting results of recent RCTs of SPN have provided clarity into the factors defining which patients may benefit from additional calories/protein and which may not. These data, combined with key, large observational studies elicit a clear call to action for trials examining the benefit of optimal calorie/protein delivery in high mortality risk, high preillness nutrition risk patients.

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Published In

Curr Opin Crit Care

DOI

EISSN

1531-7072

Publication Date

April 2012

Volume

18

Issue

2

Start / End Page

164 / 173

Location

United States

Related Subject Headings

  • Randomized Controlled Trials as Topic
  • Patient Selection
  • Parenteral Nutrition
  • Intensive Care Units
  • Humans
  • Energy Intake
  • Emergency & Critical Care Medicine
  • Dietary Proteins
  • Critical Illness
  • 3202 Clinical sciences
 

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Wischmeyer, P. (2012). Parenteral nutrition and calorie delivery in the ICU: controversy, clarity, or call to action? Curr Opin Crit Care, 18(2), 164–173. https://doi.org/10.1097/MCC.0b013e3283514be5
Wischmeyer, Paul. “Parenteral nutrition and calorie delivery in the ICU: controversy, clarity, or call to action?Curr Opin Crit Care 18, no. 2 (April 2012): 164–73. https://doi.org/10.1097/MCC.0b013e3283514be5.
Wischmeyer, Paul. “Parenteral nutrition and calorie delivery in the ICU: controversy, clarity, or call to action?Curr Opin Crit Care, vol. 18, no. 2, Apr. 2012, pp. 164–73. Pubmed, doi:10.1097/MCC.0b013e3283514be5.

Published In

Curr Opin Crit Care

DOI

EISSN

1531-7072

Publication Date

April 2012

Volume

18

Issue

2

Start / End Page

164 / 173

Location

United States

Related Subject Headings

  • Randomized Controlled Trials as Topic
  • Patient Selection
  • Parenteral Nutrition
  • Intensive Care Units
  • Humans
  • Energy Intake
  • Emergency & Critical Care Medicine
  • Dietary Proteins
  • Critical Illness
  • 3202 Clinical sciences