Muscle size, strength, and physical function in response to augmented calorie delivery: A TARGET sub-study

Chapple, Lee‐anne S.; Summers, Matthew J.; Weinel, Luke M; Lange, Kylie; Yang, Woo Han; Deane, Adam M; Chapman, Marianne J.

doi:10.1016/j.jcrc.2022.154140

Cited by 8 publications

(5 citation statements)

References 47 publications

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“…These results strengthen the evidence for a energy intake of 80%–100% after day 3, as suggested by the ESPEN guideline 2 . Another substudy of The Augmented Versus Routine Approach to Giving Energy Trial (TARGET) showed that augmented energy delivery (1.5 kcal/ml or 1.0 kcal/ml enteral formulas) was not associated with attenuated muscle loss or recovery of strength or function 6 months after ICU discharge 22 …”

Section: Energy: How To Define Targets and How Much To Supply?supporting

confidence: 78%

“…2 Another substudy of The Augmented Versus Routine Approach to Giving Energy Trial (TARGET) showed that augmented energy delivery (1.5 kcal/ml or 1.0 kcal/ml enteral formulas) was not associated with attenuated muscle loss or recovery of strength or function 6 months after ICU discharge. 22 An SRMA by Murthy and coworkers 23 aimed to determine the relationship between enteral energy intake and gastrointestinal (GI) dysfunction in critically ill adults. From 13 studies involving 6824 patients, the mean energy intake in the higher-energy group was 1673 ± 468 kcal/day as opposed to 1121 ± 312 kcal/day in the lower-energy group.…”

Section: Energy: How To Define Targets and How Much To Supply?mentioning

confidence: 99%

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

et al. 2023

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Medical nutrition therapy (MNT) represents an essential element in the medical care of critically ill patients admitted to an intensive care unit (ICU).Increasing awareness exists that energy and nutrients not only preserve body structures such as lean body/muscle mass but also represent promising therapeutic elements to target the profound metabolic, inflammatory, endocrinologic, and immunologic alterations occurring during critical illness.However, despite intense research activities for years, diverse aspects of MNT such as the optimal timing, dosing, and composition of energy and macronutrient supply, as well as the role of micronutrients, are still an issue of debate resulting from strong heterogeneity in methods and findings of respective studies. These discrepancies are also reflected in diverging recommendations of international clinical nutrition guidelines for specific topics. In addition, implementing targeted, personalized MNT strategies in routine clinical practice underlies difficulties and challenges resulting from disease-specific issues and/or organizational, structural, and educational aspects. This narrative review aims to summarize the most recent evidence relevant to clinical practice on selected aspects of MNT in adult patients in the ICU and to provide guidance for implementing evidence-based approaches for adequate energy and nutrient supply in the ICU setting.

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Section: Energy: How To Define Targets and How Much To Supply?supporting

confidence: 78%

Section: Energy: How To Define Targets and How Much To Supply?mentioning

confidence: 99%

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

et al. 2023

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“…The most recent NUTRIREA-3-RCT demonstrated faster recovery and fewer complications with early calorie and protein restriction, further supporting short-term harm by early full feeding and high protein doses [99 ▪ ]. Also in the long term, early enhanced feeding did not improve outcomes [81,100–102] or showed harm. The EPaNIC-RCT identified prolonged ICU stay and ICU-acquired neuromuscular complications, occurring more frequently with early parenteral nutrition than with late parenteral nutrition, as risk factors for worse long-term outcomes [77,103–107].…”

Section: Nutrition and Autophagy Deficiency In Critical Illnessmentioning

confidence: 87%

Nutrition and autophagy deficiency in critical illness

Vanhorebeek

Casaer

Gunst

2023

Current Opinion in Critical Care

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Purpose of review Critical illness imposes a severe insult on the body, with various stressors triggering pronounced cell damage. This compromises cellular function, leading to a high risk of multiple organ failure. Autophagy can remove damaged molecules and organelles but appears insufficiently activated during critical illness. This review discusses insight into the role of autophagy in critical illness and the involvement of artificial feeding in insufficient autophagy activation in critical illness. Recent findings Animal studies manipulating autophagy have shown its protective effects against kidney, lung, liver, and intestinal injury after several critical insults. Autophagy activation also protected peripheral, respiratory, and cardiac muscle function, despite aggravated muscle atrophy. Its role in acute brain injury is more equivocal. Animal and patient studies showed that artificial feeding suppressed autophagy activation in critical illness, particularly with high protein/amino acid doses. Feeding-suppressed autophagy may explain short and long-term harm by early enhanced calorie/protein feeding in large randomized controlled trials. Summary Insufficient autophagy during critical illness is at least partly explained by feeding-induced suppression. This may explain why early enhanced nutrition failed to benefit critically ill patients or even induced harm. Safe, specific activation of autophagy avoiding prolonged starvation opens perspectives for improving outcomes of critical illness.

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“…Early goal-directed nutrition with estimation of nutritional requirements by indirect calorimetry in the EAT-ICU-RCT did not affect short-term outcomes or physical quality-of-life at 6 months [44]. Finally, also higher calorie delivery with energy-dense as compared with routine EN in the TARGET-RCT did not affect short-term outcomes, and did not beneficially affect survival, quality-of-life, participation in work or other key life activities, disability, physical function, or muscle layer thickness 6 months later [45,54,55].…”

Section: Key Pointsmentioning

confidence: 99%

The epigenetic legacy of ICU feeding and its consequences

Vanhorebeek

Berghe²

2023

Current Opinion in Critical Care

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Purpose of reviewMany critically ill patients face physical, mental or neurocognitive impairments up to years later, the etiology remaining largely unexplained. Aberrant epigenetic changes have been linked to abnormal development and diseases resulting from adverse environmental exposures like major stress or inadequate nutrition. Theoretically, severe stress and artificial nutritional management of critical illness thus could induce epigenetic changes explaining long-term problems. We review supporting evidence.Recent findingsEpigenetic abnormalities are found in various critical illness types, affecting DNA-methylation, histone-modification and noncoding RNAs. They at least partly arise de novo after ICU-admission. Many affect genes with functions relevant for and several associate with long-term impairments. As such, de novo DNA-methylation changes in critically ill children statistically explained part of their disturbed long-term physical/neurocognitive development. These methylation changes were in part evoked by early-parenteral-nutrition (early-PN) and statistically explained harm by early-PN on long-term neurocognitive development. Finally, long-term epigenetic abnormalities beyond hospital-discharge have been identified, affecting pathways highly relevant for long-term outcomes.SummaryEpigenetic abnormalities induced by critical illness or its nutritional management provide a plausible molecular basis for their adverse effects on long-term outcomes. Identifying treatments to further attenuate these abnormalities opens perspectives to reduce the debilitating legacy of critical illness.

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Muscle size, strength, and physical function in response to augmented calorie delivery: A TARGET sub-study

Cited by 8 publications

References 47 publications

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

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

Nutrition and autophagy deficiency in critical illness

The epigenetic legacy of ICU feeding and its consequences

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