Nutrients

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Dr. Barbara Adamik

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Clinical Department of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, Borowska St. 213, 50-556 Wroclaw, Poland
Interests: nutrition; intensive care; sepsis; biomarkers; endotoxemia

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Dear Colleagues,

Nutritional support for critically ill patients is essential, but the results of multiple studies indicate that the nutrition of patients treated in the intensive care unit (ICU) is often not optimal. Factors such as inadequate nutrient intake, impaired gastric emptying, and intestinal dysmotility can lead to malnutrition, which is associated with immunosuppression, poor wound healing, and muscle weakness. In this Special Issue of Nutrients, we will discuss the usefulness of various tools for assessing nutritional status and estimating energy requirements in critically ill patients. Parenteral nutrition versus enteral nutrition and the optimal timing with which to start enteral nutrition will be discussed. Studies examining different approaches to the nutrition of ICU patients are welcome for submission.

Dr. Barbara Adamik
Guest Editor

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Keywords

critically ill
enteral nutrition
biomarkers
NUTRIC score
calories
proteins

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11 pages, 2571 KiB

Open AccessSystematic Review

Early Enteral Nutrition (within 48 h) for Patients with Sepsis or Septic Shock: A Systematic Review and Meta-Analysis

by Carlos F. Grillo-Ardila, Diego Tibavizco-Palacios, Luis C. Triana, Saúl J. Rugeles, María T. Vallejo-Ortega, Carlos H. Calderón-Franco and Juan J. Ramírez-Mosquera

Nutrients 2024, 16(11), 1560; https://doi.org/10.3390/nu16111560 - 22 May 2024

Viewed by 210

Abstract

OBJECTIVE: Medical nutrition therapy provides the opportunity to compensate for muscle wasting and immune response activation during stress and trauma. The objective of this systematic review is to assess the safety and effectiveness of early enteral nutrition (EEN) in adults with sepsis or septic shock. METHODS: The MEDLINE, Embase, CENTRAL, CINAHL, ClinicalTrials.gov, and ICTRP tools were searched from inception until July 2023. Conference proceedings, the reference lists of included studies, and expert content were queried to identify additional publications. Two review authors completed the study selection, data extraction, and risk of bias assessment; disagreements were resolved through discussion. Inclusion criteria were randomized controlled trials (RCTs) and non-randomized studies (NRSs) comparing the administration of EEN with no or delayed enteral nutrition (DEE) in adult populations with sepsis or septic shock. RESULTS: Five RCTs (n = 442 participants) and ten NRSs (n = 3724 participants) were included. Low-certainty evidence from RCTs and NRSs suggests that patients receiving EEN could require fewer days of mechanical ventilation (MD −2.65; 95% CI, −4.44–0.86; and MD −2.94; 95% CI, −3.64–−2.23, respectively) and may show lower SOFA scores during follow-up (MD −1.64 points; 95% CI, −2.60–−0.68; and MD −1.08 points; 95% CI, −1.90–−0.26, respectively), albeit with an increased frequency of diarrhea episodes (OR 2.23, 95% CI 1.115–4.34). Even though the patients with EEN show a lower in-hospital mortality rate both in RCTs (OR 0.69; 95% CI, 0.39–1.23) and NRSs (OR 0.89; 95% CI, 0.69–1.13), this difference does not achieve statistical significance. There were no apparent differences for other outcomes. CONCLUSIONS: Low-quality evidence suggests that EEN may be a safe and effective intervention for the management of critically ill patients with sepsis or septic shock. Full article

(This article belongs to the Special Issue The Impact of Nutritional Support on Improving Treatment Outcomes in Critically Ill Patients)

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The Impact of Nutritional Support on Improving Treatment Outcomes in Critically Ill Patients

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