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Open Access 01-09-2017 | Research Agenda

The intensive care medicine research agenda in nutrition and metabolism

Authors: Yaseen M. Arabi, Michael P. Casaer, Marianne Chapman, Daren K. Heyland, Carole Ichai, Paul E. Marik, Robert G. Martindale, Stephen A. McClave, Jean-Charles Preiser, Jean Reignier, Todd W. Rice, Greet Van den Berghe, Arthur R. H. van Zanten, Peter J. M. Weijs

Published in: Intensive Care Medicine | Issue 9/2017

Abstract

Purpose

The objectives of this review are to summarize the current practices and major recent advances in critical care nutrition and metabolism, review common beliefs that have been contradicted by recent trials, highlight key remaining areas of uncertainty, and suggest recommendations for the top 10 studies/trials to be done in the next 10 years.

Methods

Recent literature was reviewed and developments and knowledge gaps were summarized. The panel identified candidate topics for future trials in critical care nutrition and metabolism. Then, members of the panel rated each one of the topics using a grading system (0–4). Potential studies were ranked on the basis of average score.

Results

Recent randomized controlled trials (RCTs) have challenged several concepts, including the notion that energy expenditure must be met universally in all critically ill patients during the acute phase of critical illness, the routine monitoring of gastric residual volume, and the value of immune-modulating nutrition. The optimal protein dose combined with standardized active and passive mobilization during the acute phase and post-acute phase of critical illness were the top ranked studies for the next 10 years. Nutritional assessment, nutritional strategies in critically obese patients, and the effects of continuous versus intermittent enteral nutrition were also among the highest-ranking studies.

Conclusions

Priorities for clinical research in the field of nutritional management of critically ill patients were suggested, with the prospect that different nutritional interventions targeted to the appropriate patient population will be examined for their effect on facilitating recovery and improving survival in adequately powered and properly designed studies, probably in conjunction with physical activity.

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Title: The intensive care medicine research agenda in nutrition and metabolism
Authors: Yaseen M. Arabi
Michael P. Casaer
Marianne Chapman
Daren K. Heyland
Carole Ichai
Paul E. Marik
Robert G. Martindale
Stephen A. McClave
Jean-Charles Preiser
Jean Reignier
Todd W. Rice
Greet Van den Berghe
Arthur R. H. van Zanten
Peter J. M. Weijs
Publication date: 01-09-2017
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 9/2017
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-017-4711-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The intensive care medicine research agenda in nutrition and metabolism

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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