Optimal Protein and Energy Nutrition Decreases Mortality in Mechanically Ventilated, Critically Ill Patients

Weijs, P.J.M.; Stapel, Sandra N.; Groot, S.D.W. de; Driessen, Ronald H.; Jong, Evelien de; Girbes, Armand R. J.; Schijndel, R.J.M. Strack van; Beishuizen, Albertus

doi:10.1177/0148607111415109

Cited by 348 publications

(243 citation statements)

References 32 publications

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“…Only an observational trial [14] and three RCTs in ICU patients have based the energy target on indirect calorimetry [12,15,16]: all four trials reported clinical benefits. Petros et al [16] prospectively tested hypocaloric (50 % of measured energy needs) versus isocaloric (100 % of measured energy needs) feeding in 100 patients with an indication for nutritional support during the first 7 days after ICU admission.…”

Section: Adapting Intakes To Measured Expenditure: a Key To Successmentioning

confidence: 99%

Energy deficit is clinically relevant for critically ill patients: yes

2015

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Section: Adapting Intakes To Measured Expenditure: a Key To Successmentioning

confidence: 99%

Energy deficit is clinically relevant for critically ill patients: yes

2015

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“…An observational study showed that reaching clearly defined targets for energy and protein was associated with a decreased hazard ratio of death (18).…”

Section: Energy (Kcal) Requirementsmentioning

confidence: 99%

A Different Approach to the Nutritional Therapy in Intensive Care Units: Nutrition Software (ICNUS)

Bahar¹

2017

Turk J Anaesth Reanim

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C ritically ill patients have complex treatment needs, often with multiple organs affected. Critically ill patients are a heterogeneous population, which includes patients with traumatic injuries (e.g. injuries to the skeletal system, brain, thorax, or abdomen) or burns, systemic infections, surgical complications (e.g. major blood loss or respiratory failure) and multiple organ failure. However, a common feature of the most critical illnesses is that they all give rise to severe metabolic stress, and many critically ill patients often develop systemic inflammation. In addition, they also have increased metabolic requirements; therefore, the need for a nutritional support must also be considered (1, 2).In critically ill patients, the stress response directly influences neuroendocrine function. Changes in secretion of numerous hormones/neurotransmitters, such as acetylcholine, growth hormone and cortisol, combine to increase the body's basal metabolic rate, wherein substrates are mobilised to release energy sources (3-7). Hypercatabolism triggered by conditions of severe stress therefore increases the body's requirement for energy and protein. The increased metabolic requirements of critically ill patients are likely to accelerate the development of malnutrition, which must be considered when managing their treatment strategy (7).Compared with healthy individuals, the protein turnover is increased and more often than not, dietary protein intake is considerably reduced. Under conditions of stress, body proteins are broken down rapidly, and urinary nitrogen excretion is increased beyond normal levels. Since amino acids released from the breakdown of protein in the muscles, bones and skin are used to support, in part, to increase synthesis of proteins involved in the stress response (e.g. immunoglobulins, acuteCritically ill patients receive nutritional support in addition to extensive organ support therapies in the intensive care units. The transcription of the data obtained by multiple devices from a wide spectrum of usage areas is a challenging process and is prone to errors. Software specifically designed for usage in intensive care units do offer numerous advantages. Primarily, it facilitates to improve the management of time and workflow for the benefit of patients. Therefore, we believed that a different approach was needed for the nutritional regime of our critically ill patients. Following nearly 2 years of research, we developed and implemented the Intensive Care Nutrition Software (ICNUS), which is explained in this article. Keywords: ICNUS software, intensive care, nutrition Yoğun bakım birimlerinde yoğun organ destekleri almakta olan hastaların aynı zamanda nütrisyon tedavileri de birarada yürütül-mektedir. Çok miktarda kopuk kopuk farklı cihazlardan gelen verilerin kağıt ve dosyalara geçirilmesiyle zorluklar ve yanlış kayıtlar ortaya çıkabilmektedir. Yoğun bakıma özgü bir yazılım sistemi, yoğun bakım hastalarının takip ve tedavisinde büyük avantajlar sağ-lamaktadır. Birimimizde kullanmakta olduğumuz ya...

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“…Большинство руководств рекомендуют приме-нение энтерального питания с высоким содержанием белка (от 1,2 до 2 г на кг идеальной массы тела в сутки) для больных, находящихся в критических состояниях. Применение ЭП с высоким содержанием белка было связано со снижением уровня смертности [7,[8][9][10]. В противоположность этому энтеральное питание с низ-ким содержанием белка не оказывает никакого влияния на смертность или количество инфекционных осложне-ний у больных в критическом состоянии, но может иметь некоторое значение у отдельных больных с почечной недостаточностью [11].…”

Section: составunclassified

“…В качестве примера в одном проспективном обсерва-ционном исследовании когорты из 886 больных, нахо-дившихся на ИВЛ, отмечено сокращение на 50% 28-днев-ной смертности у больных, достигших целевого уровня белка, по сравнению с пациентами, которые достигли целевых показателей только по калоражу [9]. Энтеральное питание с низким содержанием белка не рекомендуется в качестве рутинного энтерального питания у больных с острой или хронической почечной недостаточностью.…”

Section: составunclassified

Enteral Nutrition After Advadvanced Combined Operative Interventions in Oncosurgery

Нехаев¹,

Сытов²,

Ломидзе³

2016

Med. sov.

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Энтеральное питание (ЭП) -тип лечебного или дополнительного питания специальными смесями, при котором всасыва-ние пищи (при ее поступлении через рот, через зонд в желудке или кишечнике) осуществляется физиологически адекват-ным путем, то есть через слизистую оболочку желудочно-кишечного тракта. В данном обзоре будут рассмотрены такие аспекты энтерального питания (ЭП) у больных, находящихся в отделениях реанимации и интенсивной терапии (ОРИТ), как состав, компоненты, способы доставки, осложнения ЭП.

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Optimal Protein and Energy Nutrition Decreases Mortality in Mechanically Ventilated, Critically Ill Patients

Abstract: Optimal nutritional therapy in mechanically ventilated, critically ill patients, defined as protein and energy targets reached, is associated with a decrease in 28-day mortality by 50%, whereas only reaching energy targets is not associated with a reduction in mortality.

Cited by 348 publications

References 32 publications

Energy deficit is clinically relevant for critically ill patients: yes

Energy deficit is clinically relevant for critically ill patients: yes

A Different Approach to the Nutritional Therapy in Intensive Care Units: Nutrition Software (ICNUS)

Enteral Nutrition After Advadvanced Combined Operative Interventions in Oncosurgery

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