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Does artificial nutrition improve outcome of critical illness?

Nutritional support is generally considered an essential component in the management of critically ill patients. The existing guidelines advocate early enteral nutrition, with the optimal timing for the addition of parenteral nutrition to insufficient enteral feeding being the subject of transatlant...

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Autores principales: Schetz, Miet, Casaer, Michael Paul, Van den Berghe, Greet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056754/
https://www.ncbi.nlm.nih.gov/pubmed/23375069
http://dx.doi.org/10.1186/cc11828
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author Schetz, Miet
Casaer, Michael Paul
Van den Berghe, Greet
author_facet Schetz, Miet
Casaer, Michael Paul
Van den Berghe, Greet
author_sort Schetz, Miet
collection PubMed
description Nutritional support is generally considered an essential component in the management of critically ill patients. The existing guidelines advocate early enteral nutrition, with the optimal timing for the addition of parenteral nutrition to insufficient enteral feeding being the subject of transatlantic controversy. The unphysiologic intervention of artificial nutrition in critically ill patients, however, may evoke complications and side effects. Besides the classically described complications, suppression of autophagy, potentially important for cellular repair and organ recovery, was elucidated only recently. The question whether artificial nutrition in critical illness improves or worsens outcome as compared with starvation has so far not been adequately addressed. This paper provides a critical analysis of the existing literature on ICU nutrition, highlighting important methodological shortcomings of many trials and meta-analyses and underlining the urgent need for high-quality research in this field. Recent adequately designed randomized controlled trials suggest that trophic enteral feeding during the first week of critical illness is as good as full enteral feeding and that early addition of parenteral nutrition to insufficient enteral nutrition does not provide any benefit and worsens morbidity.
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spelling pubmed-40567542014-06-14 Does artificial nutrition improve outcome of critical illness? Schetz, Miet Casaer, Michael Paul Van den Berghe, Greet Crit Care Viewpoint Nutritional support is generally considered an essential component in the management of critically ill patients. The existing guidelines advocate early enteral nutrition, with the optimal timing for the addition of parenteral nutrition to insufficient enteral feeding being the subject of transatlantic controversy. The unphysiologic intervention of artificial nutrition in critically ill patients, however, may evoke complications and side effects. Besides the classically described complications, suppression of autophagy, potentially important for cellular repair and organ recovery, was elucidated only recently. The question whether artificial nutrition in critical illness improves or worsens outcome as compared with starvation has so far not been adequately addressed. This paper provides a critical analysis of the existing literature on ICU nutrition, highlighting important methodological shortcomings of many trials and meta-analyses and underlining the urgent need for high-quality research in this field. Recent adequately designed randomized controlled trials suggest that trophic enteral feeding during the first week of critical illness is as good as full enteral feeding and that early addition of parenteral nutrition to insufficient enteral nutrition does not provide any benefit and worsens morbidity. BioMed Central 2013 2013-02-01 /pmc/articles/PMC4056754/ /pubmed/23375069 http://dx.doi.org/10.1186/cc11828 Text en Copyright © 2013 BioMed Central Ltd
spellingShingle Viewpoint
Schetz, Miet
Casaer, Michael Paul
Van den Berghe, Greet
Does artificial nutrition improve outcome of critical illness?
title Does artificial nutrition improve outcome of critical illness?
title_full Does artificial nutrition improve outcome of critical illness?
title_fullStr Does artificial nutrition improve outcome of critical illness?
title_full_unstemmed Does artificial nutrition improve outcome of critical illness?
title_short Does artificial nutrition improve outcome of critical illness?
title_sort does artificial nutrition improve outcome of critical illness?
topic Viewpoint
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056754/
https://www.ncbi.nlm.nih.gov/pubmed/23375069
http://dx.doi.org/10.1186/cc11828
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