Early Versus Late Parenteral Nutrition in Critically Ill Adults

Trial of the Route of Early Nutritional Support in Critically Ill Adults

“…Although these findings are consistent with those of previous trials evaluating the enteral route in critically ill patients, 6,7 the presumption is that the parenteral route is more reliable in guaranteeing delivery. 10,11 Possible contributory reasons as to why the parenteral route did not meet its caloric target include lack of availability of nutritional product, content (the use of commercially available rather than individually titrated product), delivery (delays or interruptions in delivery for procedures, transfers, patient factors, etc. ), and clinical preference.…”

Adequate enteral feeding in the pediatric intensive care unit may be associated with fewer nosocomial infections and deaths

“…Because younger age was associated with a higher percentage of energy intake from EN it would be of more interest to focus on the intake per age group, especially because goals for energy and protein differ substantially between age groups. It is not clear in this study whether supplemental PN increased mortality risk, as was shown recently in a multicentre study in critically ill adults 2. As clinical outcomes may be impaired with supplemental PN, the use of supplemental PN as a tool to achieve nutritional goals in critically ill children should be further studied.…”

Glucose Control

“…Total parenteral nutrition (TPN)-related hyperglycemia is associated with increased mortality [14], suggesting that glycemic control should be tighter in patients receiving TPN. However, even when TGC is applied successfully, early high caloric intake by TPN to complement insufficient enteral nutrition is associated with poorer outcome than in the case of late TPN [15].…”