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Critical Care
Published in: Critical Care 1/2017

Open Access 01-12-2017 | Review

The role of nutritional support in the physical and functional recovery of critically ill patients: a narrative review

Authors: Danielle E. Bear, Liesl Wandrag, Judith L. Merriweather, Bronwen Connolly, Nicholas Hart, Michael P. W. Grocott, on behalf of the Enhanced Recovery After Critical Illness Programme Group (ERACIP) investigators

Published in: Critical Care | Issue 1/2017

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Abstract

The lack of benefit from randomised controlled trials has resulted in significant controversy regarding the role of nutrition during critical illness in terms of long-term recovery and outcome. Although methodological caveats with a failure to adequately appreciate biological mechanisms may explain these disappointing results, it must be acknowledged that nutritional support during early critical illness, when considered alone, may have limited long-term functional impact.
This narrative review focuses specifically on recent clinical trials and evaluates the impact of nutrition during critical illness on long-term physical and functional recovery.
Specific focus on the trial design and methodological limitations has been considered in detail. Limitations include delivery of caloric and protein targets, patient heterogeneity, short duration of intervention, inappropriate clinical outcomes and a disregard for baseline nutritional status and nutritional intake in the post-ICU period.
With survivorship at the forefront of critical care research, it is imperative that nutrition studies carefully consider biological mechanisms and trial design because these factors can strongly influence outcomes, in particular long-term physical and functional outcome. Failure to do so may lead to inconclusive clinical trials and consequent rejection of the potentially beneficial effects of nutrition interventions during critical illness.
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Metadata
Title
The role of nutritional support in the physical and functional recovery of critically ill patients: a narrative review
Authors
Danielle E. Bear
Liesl Wandrag
Judith L. Merriweather
Bronwen Connolly
Nicholas Hart
Michael P. W. Grocott
on behalf of the Enhanced Recovery After Critical Illness Programme Group (ERACIP) investigators
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2017
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-017-1810-2

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