Parenteral nutrition in the intensive care unit: cautious use improves outcome.

Détails

Ressource 1Télécharger: 25144728.pdf (630.57 [Ko])
Etat: Serval
Version: Final published version
ID Serval
serval:BIB_82291011E116
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Parenteral nutrition in the intensive care unit: cautious use improves outcome.
Périodique
Swiss medical weekly
Auteur(s)
Thibault R., Heidegger C.P., Berger M.M., Pichard C.
ISSN
1424-3997 (Electronic)
ISSN-L
0036-7672
Statut éditorial
Publié
Date de publication
2014
Peer-reviewed
Oui
Volume
144
Pages
w13997
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Publication Status: epublish
Résumé
Critical illness is characterised by nutritional and metabolic disorders, resulting in increased muscle catabolism, fat-free mass loss, and hyperglycaemia. The objective of the nutritional support is to limit fat-free mass loss, which has negative consequences on clinical outcome and recovery. Early enteral nutrition is recommended by current guidelines as the first choice feeding route in ICU patients. However, enteral nutrition alone is frequently associated with insufficient coverage of the energy requirements, and subsequently energy deficit is correlated to worsened clinical outcome. Controlled trials have demonstrated that, in case of failure or contraindications to full enteral nutrition, parenteral nutrition administration on top of insufficient enteral nutrition within the first four days after admission could improve the clinical outcome, and may attenuate fat-free mass loss. Parenteral nutrition is cautious if all-in-one solutions are used, glycaemia controlled, and overnutrition avoided. Conversely, the systematic use of parenteral nutrition in the ICU patients without clear indication is not recommended during the first 48 hours. Specific methods, such as thigh ultra-sound imaging, 3rd lumbar vertebra-targeted computerised tomography and bioimpedance electrical analysis, may be helpful in the future to monitor fat-free mass during the ICU stay. Clinical studies are warranted to demonstrate whether an optimal nutritional management during the ICU stay promotes muscle mass and function, the recovery after critical illness and reduces the overall costs.

Mots-clé
Critical Care/methods, Critical Illness/therapy, Energy Intake, Energy Metabolism, Enteral Nutrition, Humans, Nutrition Assessment, Parenteral Nutrition/adverse effects, Treatment Outcome
Pubmed
Web of science
Création de la notice
09/10/2014 18:26
Dernière modification de la notice
03/03/2018 18:49
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