4.7 Review

Monitoring nutrition in the ICU

Journal

CLINICAL NUTRITION
Volume 38, Issue 2, Pages 584-593

Publisher

CHURCHILL LIVINGSTONE
DOI: 10.1016/j.clnu.2018.07.009

Keywords

Critical illness; Energy balance; Glucose; Phosphate; Standard operating procedures

Ask authors/readers for more resources

Background & aims: This position paper summarizes theoretical and practical aspects of the monitoring of artificial nutrition and metabolism in critically ill patients, thereby completing ESPEN guidelines on intensive care unit (ICU) nutrition. Methods: Available literature and personal clinical experience on monitoring of nutrition and metabolism was systematically reviewed by the ESPEN group for ICU nutrition guidelines. Results: We did not identify any studies comparing outcomes with monitoring versus not monitoring nutrition therapy. The potential for abnormal values to be associated with harm was clearly recognized. The necessity to create locally adapted standard operating procedures (SOPs) for follow up of enteral and parenteral nutrition is emphasised. Clinical observations, laboratory parameters (including blood glucose, electrolytes, triglycerides, liver tests), and monitoring of energy expenditure and body composition are addressed, focusing on prevention, and early detection of nutrition-related complications. Conclusion: Understanding and defining risks and developing local SOPs are critical to reduce specific risks. (C) 2018 Published by Elsevier Ltd.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.7
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

Article Sport Sciences

Effects of 12 Wk of Omega-3 Fatty Acid Supplementation in Long-Distance Runners

Maja Tomczyk, Zbigniew Jost, Maciej Chroboczek, Robert Urbanski, Philip C. Calder, Helena L. Fisk, Mateusz Sprengel, Jedrzej Antosiewicz

Summary: The study aimed to investigate the effects of 12 wk of omega-3 fatty acid supplementation during endurance training on omega-3 index (O3I) and indicators of running performance in amateur long-distance runners. The results showed a significant increase in O3I, improvements in (V) over dotO(2peak) and running economy, but no significant effect on the 1500-m run trial time.

MEDICINE & SCIENCE IN SPORTS & EXERCISE (2023)

Article Biochemistry & Molecular Biology

Conjugated Linoleic Acids Have Anti-Inflammatory Effects in Cultured Endothelial Cells

Carina A. Valenzuela, Ella J. Baker, Elizabeth A. Miles, Philip C. Calder

Summary: Conjugated linoleic acid (CLA) isomers, specifically cis-9, trans-11 (CLA9,11) and trans-10, cis-12 (CLA10,12), have shown modest anti-inflammatory effects on endothelial cells (ECs) at low concentrations. These CLAs decrease the concentrations of inflammatory factors such as MCP-1, IL-6, IL-8, and RANTES in the culture medium, but also upregulate some pro-inflammatory genes while downregulating others. The findings suggest that CLAs may have a role in preventing atherosclerosis by modulating inflammation in ECs.

INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES (2023)

Article Biochemistry & Molecular Biology

Influence of Dietary n-3 Long Chain Polyunsaturated Fatty Acid Intake on Oxylipins in Erythrocytes of Women with Rheumatoid Arthritis

Helen M. M. Lindqvist, Anna Winkvist, Inger Gjertsson, Philip C. C. Calder, Aaron M. M. Armando, Oswald Quehenberger, Roxana Coras, Monica Guma

Summary: A study on patients with rheumatoid arthritis found that consuming blue mussels, which are rich in n-3 fatty acids, led to significant changes in certain oxylipin levels, but did not have a noticeable impact on inflammation. Further research is needed to investigate the relationship between n-3 fatty acid intake, blood oxylipins, and inflammation.

MOLECULES (2023)

Article Nutrition & Dietetics

Management of acute mesenteric ischaemia: Results of a worldwide survey

Benjamin Hess, Martin Cahenzli, Alastair Forbes, Rosa Burgos, Federico Coccolini, Olivier Corcos, Mette Holst, Oivind Irtun, Stanislaw Klek, Loris Pironi, Henrik Hojgaard Rasmussen, Mireille J. Serlie, Ronan Thibault, Simon Gabe, Annika Reintam Blaser

Summary: This survey assesses current attitudes and practices in managing acute mesenteric ischemia (AMI) worldwide. Results show that diagnosis of AMI is often delayed but rarely missed. Abdominopelvic CT-scan with intravenous contrast was suggested as the most useful diagnostic test. Treatment approaches vary greatly, indicating the need for updated guidelines.

CLINICAL NUTRITION ESPEN (2023)

Article Endocrinology & Metabolism

Skeletal Muscle Myokine Expression in Critical Illness, Association With Outcome and Impact of Therapeutic Interventions

Ilse Vanhorebeek, Jan Gunst, Michael P. Casaer, Inge Derese, Sarah Derde, Lies Pauwels, Johan Segers, Greet Hermans, Rik Gosselink, Greet van den Berghe

Summary: This study investigated the impact of critical illness on muscular expression of irisin, kynurenine aminotransferases, and amylase, and their association with clinical outcomes, as well as the effects of interventions that attenuate muscle wasting/weakness. The findings showed that critically ill patients had lower mRNA expression levels of FNDC5, KYAT1, and amylase compared to controls. Lower expression of FNDC5 was associated with higher ICU mortality and ICU-acquired weakness, while lower amylase expression was associated with longer ICU stay. Lower KYAT1 expression was associated with a lower risk of weakness. The study also found that neuromuscular electrical stimulation increased FNDC5 expression and that late parenteral nutrition patients had higher KYAT1 expression compared to early parenteral nutrition patients.

JOURNAL OF THE ENDOCRINE SOCIETY (2023)

Review Nutrition & Dietetics

The Impact of Linoleic Acid on Infant Health in the Absence or Presence of DHA in Infant Formulas

Alexandra W. C. Einerhand, Wiola Mi, Alfred Haandrikman, Xiao-Yang Sheng, Philip C. Calder

Summary: Linoleic acid and α-linolenic acid are essential fatty acids crucial for health. Levels of linoleic acid in breast milk and infant formula vary across countries, and this study aims to review the global levels of these fatty acids and their impact on infant formula health benefits based on published literature.

NUTRIENTS (2023)

Article Nutrition & Dietetics

Macronutrient intake and outcomes of ICU patients with refeeding hypophosphatemia

Rianne Slingerland-Boot, Eveline Rooijakkers, Kristine Koekkoek, Dick van Blokland, Sesmu Arbous, Arthur van Zanten

Summary: This study evaluates the associations between macronutrient intake and clinical outcomes in ICU patients with refeeding hypophosphatemia. The results suggest that high protein intake during the first three days of ICU admission is associated with increased 6-month mortality.

CLINICAL NUTRITION ESPEN (2023)

Article Agricultural Economics & Policy

Impacts of the Ukraine-Russia Conflict on the Global Food Supply Chain and Building Future ResilienceDie Auswirkungen des Ukraine-Russland-Konflikts auf die globale Lebensmittelwarenkette und der Aufbau von kunftiger Resilienz

Ellen Dyson, Rachel Helbig, Tessa Avermaete, Kate Halliwell, Philip C. Calder, Lynn R. Brown, John Ingram, Bert Popping, Hans Verhagen, Alan R. Boobis, Isabelle Guelinckx, Louise Dye, Neil Boyle

Summary: The reverberations of the Ukraine-Russia conflict have had a profound global impact in 2022, exacerbating existing pressures on global systems. The vulnerabilities of the global food system have been exposed, resulting in disruptions to food supply chains and disproportionately affecting vulnerable populations in the Global South.

EUROCHOICES (2023)

Article Nutrition & Dietetics

The impact of fish oil and/or probiotics on serum fatty acids and the interaction with low-grade inflammation in pregnant women with overweight and obesity: secondary analysis of a randomised controlled trial

Noora Houttu, Tero Vahlberg, Elizabeth A. Miles, Philip C. Calder, Kirsi Laitinen

Summary: This study investigates the impact of fish oil and probiotics on serum fatty acids in pregnant women, as well as the relationship between fatty acids, low-grade inflammation, and gestational diabetes mellitus (GDM). The results show that pregnant women who consume fish oil and/or probiotics have higher levels of n-3 long-chain PUFA (LC-PUFA) in their serum, but these fatty acids are negatively correlated with low-grade inflammation and positively correlated with the risk of GDM.

BRITISH JOURNAL OF NUTRITION (2023)

Article Nutrition & Dietetics

ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit

Pierre Singer, Annika Reintam Blaser, Mette M. Berger, Philip C. Calder, Michael Casaer, Michael Hiesmayr, Konstantin Mayer, Juan Carlos Montejo-Gonzalez, Claude Pichard, Jean -Charles Preiser, Wojciech Szczeklik, Arthur R. H. van Zanten, Stephan C. Bischoff

Summary: Following the new ESPEN Standard Operating Procedures, the previous 2019 guideline on medical nutrition therapy for critically ill patients has been shortened and partially revised. This publication proposes a practical guideline based on the published scientific guideline, but with shortened and illustrated flow charts. The main goal of this practical guideline is to increase understanding and facilitate implementation of Nutrition in the ICU guidelines, including all items discussed in the previous guidelines and special conditions.

CLINICAL NUTRITION (2023)

Review Critical Care Medicine

Toward nutrition improving outcome of critically ill patients: How to interpret recent feeding RCTs?

Jan Gunst, Michael. P. P. Casaer, Jean-Charles Preiser, Jean Reignier, Greet van den Berghe

Summary: Recent randomized controlled trials have shown that early full nutritional support does not benefit critically ill patients and may cause harm. The absence of benefit may not be due to low nutritional risk patients or low amino acid doses, as previously hypothesized. Mechanistic studies suggest that the lack of benefit is due to anabolic resistance and suppression of recovery-enhancing pathways induced by feeding. Large randomized controlled trials have not investigated the impact of different feeding strategies initiated after the acute phase in patients recovering from critical illness.

CRITICAL CARE (2023)

Review Nutrition & Dietetics

Athletes Can Benefit from Increased Intake of EPA and DHA-Evaluating the Evidence

Maja Tomczyk, Jeffery L. Heileson, Miroslaw Babiarz, Philip C. Calder

Summary: Fatty fish and certain species of algae are the only natural sources of EPA and DHA, which have various beneficial effects for athletes. Due to limited intake and fluctuating content, athletes may consider using supplements to ensure sufficient EPA and DHA levels.

NUTRIENTS (2023)

Review Nutrition & Dietetics

Vital role for primary healthcare providers: urgent need to educate the community about daily nutritional self-care to support immune function and maintain health

Philip C. Calder, Anna Bach-Faig, Teresa Bevacqua, Chrystopherson Gengyny Caballero Lopez, Zheng-Yu Chen, Daragh Connolly, Wan Lee Koay, Simin N. Meydani, Ari-Sentug Pinar, Durval Ribas-Filho, Adeline Pierre

Summary: Self-care is important for improving health and social well-being. Understanding how the body works and how to keep it healthy is crucial. The immune system plays a vital role in defending against pathogens and maintaining overall health. Active management of the immune system is necessary to reduce the risk of chronic diseases. A healthy and diverse diet, along with regular exercise, adequate sleep, and mental resilience, is key to supporting immune function.

BMJ NUTRITION, PREVENTION & HEALTH (2023)

Article Critical Care Medicine

Gastric residual volume monitoring practices in UK intensive care units: A web-based survey

Bethan Jenkins, Philip C. Calder, Luise Marino

Summary: This study surveyed the current practice of enteral feeding and gastric residual volume (GRV) monitoring in UK adult ICUs, and described the impact of GRV monitoring on enteral feeding. The results showed that despite the poor validity of GRV measurement, it is still commonly used in UK adult ICUs to assess enteral feeding intolerance. This suggests the need for further research on the benefits of ongoing GRV measurements and alternative markers of enteral feeding intolerance in the adult ICU population.

JOURNAL OF THE INTENSIVE CARE SOCIETY (2023)

Article Nutrition & Dietetics

Individualised energy and protein targets achieved during intensive care admission are associated with lower mortality in mechanically ventilated COVID-19 patients: The COFEED-19 study

Max Melchers, Anoek Jacqueline Hubertine Hermans, Suzanne Belia Hulsen, Imre Willemijn Kehinde Kouw, Arthur Raymond Hubert van Zanten

Summary: This study highlights the importance of providing adequate nutritional therapy to COVID-19 patients in the ICU who require invasive mechanical ventilation. Meeting over 80% of the protein goals based on BIA-derived FFM was associated with lower mortality rates.

CLINICAL NUTRITION (2023)

No Data Available