Top

Published in:

01-11-2019 | Nutrition | Less is more in Intensive Care

Less is more in nutrition: critically ill patients are starving but not hungry

Authors: Yaseen M. Arabi, Annika Reintam Blaser, Jean-Charles Preiser

Published in: Intensive Care Medicine | Issue 11/2019

Excerpt

Critical illness is associated with a metabolic response that is considered as adaptive and is mediated by increase in sympathetic nervous system activity and release of pituitary hormones and inflammatory mediators [1]. At the same time, resistance to anabolic agents develops and the pathways for energy production are modified to facilitate the use of alternative substrates [1]. While these mechanisms are triggered to increase the availability of energy substrates, they lead to substantial catabolic state and loss of muscle mass. …

Preiser JC, Ichai C, Orban JC, Groeneveld AB (2014) Metabolic response to the stress of critical illness. Br J Anaesth 113(6):945–954CrossRefPubMed

Langhans W (2007) Signals generating anorexia during acute illness. Proc Nutr Soc 66(3):321–330CrossRefPubMed

Tzanela M, Orfanos S, Tsirantonaki M et al (2006) Leptin alterations in the course of sepsis in humans. In Vivo 20(4):565–570PubMed

Nematy M, O’Flynn JE, Wandrag L et al (2006) Changes in appetite related gut hormones in intensive care unit patients: a pilot cohort study. Crit Care 10(1):R10CrossRefPubMed

van Niekerk G, Isaacs AW, Nell T, Engelbrecht AM (2016) Sickness-associated anorexia: mother nature’s idea of immunonutrition? Mediat Inflamm 2016:8071539

McClave SA, Lowen CC, Martindale RG (2018) The 2016 ESPEN Arvid Wretlind lecture: the gut in stress. Clin Nutr 37(1):19–36CrossRefPubMed

Tian F, Heighes PT, Allingstrup MJ, Doig GS (2018) Early enteral nutrition provided within 24 hours of ICU admission: a meta-analysis of randomized controlled trials. Crit Care Med 46(7):1049–1056CrossRefPubMed

Wang A, Huen SC, Luan HH et al (2016) Opposing effects of fasting metabolism on tissue tolerance in bacterial and viral inflammation. Cell 166(6):1512–1525CrossRefPubMedPubMedCentral

National Heart L, Blood Institute Acute Respiratory Distress S, Rice TW et al (2012) Initial trophic vs full enteral feeding in patients with acute lung injury: the EDEN randomized trial. JAMA 307(8):795–803CrossRef

10.

Arabi YM, Aldawood AS, Haddad SH et al (2015) Permissive underfeeding or standard enteral feeding in critically ill adults. N Engl J Med 372(25):2398–2408CrossRefPubMed

11.

Al-Dorzi HM, Albarrak A, Ferwana M, Murad MH, Arabi YM (2016) Lower versus higher dose of enteral caloric intake in adult critically ill patients: a systematic review and meta-analysis. Crit Care 20(1):358CrossRefPubMedPubMedCentral

12.

Target Investigators ftACTG, Chapman M, Peake SL et al (2018) Energy-dense versus routine enteral nutrition in the critically ill. N Engl J Med 379(19):1823–1834CrossRef

13.

Singer P, Blaser AR, Berger MM et al (2019) ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr 38(1):48–79CrossRefPubMed

14.

Casaer MP, Mesotten D, Hermans G et al (2011) Early versus late parenteral nutrition in critically ill adults. N Engl J Med 365(6):506–517CrossRefPubMed

15.

Fivez T, Kerklaan D, Mesotten D et al (2016) Early versus late parenteral nutrition in critically ill children. N Engl J Med 374(12):1111–1122CrossRefPubMed

16.

Elke G, van Zanten AR, Lemieux M et al (2016) Enteral versus parenteral nutrition in critically ill patients: an updated systematic review and meta-analysis of randomized controlled trials. Crit Care 20(1):117CrossRefPubMedPubMedCentral

17.

Heyland DK, Dhaliwal R, Jiang X, Day AG (2011) Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool. Crit Care 15(6):R268CrossRefPubMedPubMedCentral

18.

Arabi YM, Aldawood AS, Al-Dorzi HM et al (2017) Permissive underfeeding or standard enteral feeding in high and low nutritional risk critically ill adults: post-hoc analysis of the PermiT trial. Am J Respir Crit Care Med 195:652–662CrossRefPubMed

19.

Doig GS, Simpson F, Heighes PT et al (2015) Restricted versus continued standard caloric intake during the management of refeeding syndrome in critically ill adults: a randomised, parallel-group, multicentre, single-blind controlled trial. Lancet Respir Med 3(12):943–952CrossRefPubMed

20.

Reignier J, Boisrame-Helms J, Brisard L et al (2018) Enteral versus parenteral early nutrition in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2). Lancet 391(10116):133–143CrossRefPubMed

Title: Less is more in nutrition: critically ill patients are starving but not hungry
Authors: Yaseen M. Arabi
Annika Reintam Blaser
Jean-Charles Preiser
Publication date: 01-11-2019
Publisher: Springer Berlin Heidelberg
Keyword: Nutrition
Published in: Intensive Care Medicine / Issue 11/2019
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-019-05765-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Less is more in nutrition: critically ill patients are starving but not hungry

Excerpt

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 11/2019

Choosing the right or left for the subclavian venous cannulation?

ECCO2R patients: look out for coloured urine

My wife’s turn in the ICU

Highly prolific authors in critical care: which factors influence their scientific output?

Less is more: ten reasons for considering to discontinue unproven interventions

CORE-REA: COPD right heart and respiratory acidosis