Meeting nutritional targets of critically ill patients by combined enteral and parenteral nutrition: review and rationale for the EFFORTcombo trial.

Nutrition Research Reviews
Aileen HillChristian Stoppe

Abstract

While medical nutrition therapy is an essential part of the care for critically ill patients, uncertainty exists about the right form, dosage, timing and route in relation to the phases of critical illness. As enteral nutrition (EN) is often withheld or interrupted during the intensive care unit (ICU) stay, combined EN and parenteral nutrition (PN) may represent an effective and safe option to achieve energy and protein goals as recommended by international guidelines. We hypothesise that critically ill patients at high nutritional risk may benefit from such a combined approach during their stay on the ICU. Therefore, we aim to test if an early combination of EN and high-protein PN (EN+PN) is effective in reaching energy and protein goals in patients at high nutritional risk, while avoiding overfeeding. This approach will be tested in the here-presented EFFORTcombo trial. Nutritionally high-risk ICU patients will be randomised to either high (≥2·2 g/kg per d) or low protein (≤1·2 g/kg per d). In the high protein group, the patients will receive EN+PN; in the low protein group, patients will be given EN alone. EN will be started in accordance with international guidelines in both groups. Efforts will be made to reach nutrition g...Continue Reading

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Citations

Feb 5, 2021·Current Opinion in Clinical Nutrition and Metabolic Care·Zudin Puthucheary, Jan Gunst
Dec 15, 2020·Current Opinion in Clinical Nutrition and Metabolic Care·Emma J Ridley
Apr 27, 2021·JPEN. Journal of Parenteral and Enteral Nutrition·Aileen HillChristian Stoppe
Aug 28, 2021·Nutrients·Aileen HillArved Weimann

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