Journal ArticleDOI
Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)
Nilesh M. Mehta,Heather E. Skillman,Sharon Y. Irving,Jorge A. Coss-Bu,Sarah Vermilyea,Elizabeth Anne Farrington,Liam McKeever,Amber M. Hall,Praveen S. Goday,Carol L. Braunschweig +9 more
TLDR
The guidelines reiterate the importance of nutrition assessment-particularly, the detection of malnourished patients who are most vulnerable and therefore may benefit from timely intervention and there is a need for renewed focus on accurate estimation of energy needs and attention to optimizing protein intake.Abstract:
This document represents the first collaboration between 2 organizations-the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine-to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric critically ill patient (>1 month and 2-3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2032 citations were scanned for relevance. The PubMed/MEDLINE search resulted in 960 citations for clinical trials and 925 citations for cohort studies. The EMBASE search for clinical trials culled 1661 citations. In total, the search for clinical trials yielded 1107 citations, whereas the cohort search yielded 925. After careful review, 16 randomized controlled trials and 37 cohort studies appeared to answer 1 of the 8 preidentified question groups for this guideline. We used the GRADE criteria (Grading of Recommendations, Assessment, Development, and Evaluation) to adjust the evidence grade based on assessment of the quality of study design and execution. These guidelines are not intended for neonates or adult patients. The guidelines reiterate the importance of nutrition assessment-particularly, the detection of malnourished patients who are most vulnerable and therefore may benefit from timely intervention. There is a need for renewed focus on accurate estimation of energy needs and attention to optimizing protein intake. Indirect calorimetry, where feasible, and cautious use of estimating equations and increased surveillance for unintended caloric underfeeding and overfeeding are recommended. Optimal protein intake and its correlation with clinical outcomes are areas of great interest. The optimal route and timing of nutrient delivery are areas of intense debate and investigations. Enteral nutrition remains the preferred route for nutrient delivery. Several strategies to optimize enteral nutrition during critical illness have emerged. The role of supplemental parenteral nutrition has been highlighted, and a delayed approach appears to be beneficial. Immunonutrition cannot be currently recommended. Overall, the pediatric critical care population is heterogeneous, and a nuanced approach to individualizing nutrition support with the aim of improving clinical outcomes is necessary.read more
Citations
More filters
Journal ArticleDOI
Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group
Juergen M. Bauer,Gianni Biolo,Tommy Cederholm,Matteo Cesari,Alfonso J. Cruz-Jentoft,John E. Morley,Stuart M. Phillips,Cornel C. Sieber,Peter Stehle,Daniel Teta,Renuka Visvanathan,Elena Volpi,Yves Boirie +12 more
TL;DR: To help older people (>65 years) maintain and regain lean body mass and function, the PROT-AGE study group recommends average daily intake at least in the range of 1.2 g protein per kilogram of body weight per day.
Journal ArticleDOI
Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1).
John A. Kellum,Norbert Lameire +1 more
TL;DR: Key aspects of the guideline including definition and staging of AKI, as well as evaluation and nondialytic management are summarized, including treatment recommendations based on systematic reviews of relevant trials.
Journal ArticleDOI
ESPEN guideline: Clinical nutrition in surgery
Arved Weimann,Marco Braga,Franco Carli,Takashi Higashiguchi,Martin Hübner,Stanislaw Klek,Alessandro Laviano,Olle Ljungqvist,Dileep N. Lobo,Robert G. Martindale,Dan Linetzky Waitzberg,Stephan C. Bischoff,Pierre Singer +12 more
TL;DR: The focus of this guideline is to cover nutritional aspects of the Enhanced Recovery After Surgery (ERAS) concept and the special nutritional needs of patients undergoing major surgery, e.g. for cancer, and of those developing severe complications despite best perioperative care.
Journal ArticleDOI
American association of clinical endocrinologists and american college of endocrinology - clinical practice guidelines for developing a diabetes mellitus comprehensive care plan - 2015.
Yehuda Handelsman,Zachary T. Bloomgarden,George Grunberger,Guillermo E. Umpierrez,Robert S. Zimmerman,Timothy S. Bailey,Lawrence Blonde,George A. Bray,A. Jay Cohen,Samuel Dagogo-Jack,Jaime A. Davidson,Daniel Einhorn,Om P. Ganda,Alan J. Garber,W. Timothy Garvey,Robert R. Henry,Irl B. Hirsch,Edward S. Horton,Daniel L. Hurley,Paul S. Jellinger,Lois Jovanovič,Harold E. Lebovitz,Derek LeRoith,Philip T. Levy,Janet B. McGill,Jeffrey I. Mechanick,Jorge H. Mestman,Etie S. Moghissi,Eric A. Orzeck,Rachel Pessah-Pollack,Paul D. Rosenblit,Aaron I. Vinik,Kathleen Wyne,Farhad Zangeneh +33 more
TL;DR: These guidelines are a working document that reflects the state of the field at the time of publication and any decision by practitioners to apply these guidelines must be made in light of local resources and individual patient circumstances.
Journal ArticleDOI
Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool
TL;DR: This scoring algorithm may be helpful in identifying critically ill patients most likely to benefit from aggressive nutrition therapy in the intensive care unit (ICU), and based on the statistical significance in the multivariable model, the final score used all candidate variables except BMI.
References
More filters
Journal ArticleDOI
Intensive Insulin Therapy in Critically Ill Patients
Greet Van den Berghe,Pieter Wouters,Frank Weekers,Charles Verwaest,Frans Bruyninckx,Miet Schetz,Dirk Vlasselaers,Patrick Ferdinande,Peter Lauwers,Roger Bouillon +9 more
TL;DR: Intensive insulin therapy to maintain blood glucose at or below 110 mg per deciliter reduces morbidity and mortality among critically ill patients in the surgical intensive care unit.
Journal ArticleDOI
KDIGO clinical practice guidelines for acute kidney injury.
TL;DR: The guidelines focused on 4 key domains: (1) AKI definition, (2) prevention and treatment of AKI, (3) contrastinduced AKI (CI-AKI) and (4) dialysis interventions for the treatment ofAKI.
Journal ArticleDOI
Intensive versus conventional glucose control in critically ill patients.
Nice-Sugar Study Investigators,Dean R. Chittock,Steve Su,D. Blair,Denise Foster,Rinaldo Bellomo,Deborah J. Cook,Vinay Dhingra,Peter Dodek,Paul C. Hébert,William R. Henderson,Stephane Heritier,Daren K. Heyland,Colin McArthur,Ellen McDonald,Imogen Mitchell,Robyn Norton,J. Potter,Bruce G. Robinson,Juan J. Ronco +19 more
TL;DR: In this large, international, randomized trial, it was found that intensive glucose control increased mortality among adults in the ICU: a blood glucose target of 180 mg or less per deciliter resulted in lower mortality than did a target of 81 to 108 mg perDeciliter.
Journal ArticleDOI
Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock
R. Phillip Dellinger,Jean Carlet,Henry Masur,Herwig Gerlach,Thierry Calandra,Jonathan Cohen,Juan Gea-Banacloche,Didier Keh,John C. Marshall,Margaret M. Parker,Graham Ramsay,Janice L. Zimmerman,Jean Louis Vincent,Mitchell M. Levy +13 more
TL;DR: Evidence-based recommendations can be made regarding many aspects of the acute management of sepsis and septic shock that will hopefully translate into improved outcomes for the critically ill patient.
Journal ArticleDOI
Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus
Peter A. Banks,Thomas L. Bollen,Christos Dervenis,Hein G. Gooszen,Colin D. Johnson,Michael G. Sarr,Gregory G. Tsiotos,Santhi Swaroop Vege +7 more
TL;DR: This international, web-based consensus provides clear definitions to classify acute pancreatitis using easily identified clinical and radiologic criteria and should encourage widespread adoption.
Related Papers (5)
ESPEN guideline on clinical nutrition in the intensive care unit
Early versus Late Parenteral Nutrition in Critically Ill Adults
Michael P Casaer,Dieter Mesotten,Greet Hermans,Pieter Wouters,Miet Schetz,Geert Meyfroidt,Sophie Van Cromphaut,Catherine Ingels,Philippe Meersseman,Jan Muller,Dirk Vlasselaers,Yves Debaveye,Lars Desmet,Jasperina Dubois,Aimé Van Assche,Simon Vanderheyden,Alexander Wilmer,Greet Van den Berghe +17 more