Skip to main content
Top
Published in: Critical Care 5/2009

01-10-2009 | Commentary

Toward protein-energy goal-oriented therapy?

Author: Pierre Singer

Published in: Critical Care | Issue 5/2009

Login to get access

Abstract

Protein calorie malnutrition is a concern in critically ill patients. Prospective studies to define the ideal calorie/protein intake to administer not only to meet requirements but also to change outcome are lacking. Strack van Schijndel and colleagues have observed an improvement in survival when patients reach the calorie target according to indirect calorimetry and a protein intake of greater than 1.2 g/kg per day. Their prospective observational study sheds new light on this field.
Literature
1.
go back to reference Strack van Schijndel RJ, Weijs PJ, Koopmans RH, Sauerwein HP, Beishuizen A, Girbes AR: Optimal nutrition during the period of mechanical ventilation decreases mortality in critically ill, long-term acute female patients: a prospective observational cohort study. Crit Care 2009, 13: R132. 10.1186/cc7993PubMedCentralCrossRefPubMed Strack van Schijndel RJ, Weijs PJ, Koopmans RH, Sauerwein HP, Beishuizen A, Girbes AR: Optimal nutrition during the period of mechanical ventilation decreases mortality in critically ill, long-term acute female patients: a prospective observational cohort study. Crit Care 2009, 13: R132. 10.1186/cc7993PubMedCentralCrossRefPubMed
2.
go back to reference Kreymann KG, Berger MM, Deutz NE, Hiesmayr M, Jolliet P, Kazandjiev G, Nitenberg G, Berghe G, Wernerman J, DGEM (German Society for Nutritional Medicine), Ebner C, Hartl W, Heymann C, Spies C, ESPEN (European Society for Parenteral and Enteral Nutrition): ESPEN guidelines on enteral nutrition: intensive care. Clin Nutr 2006, 25: 210-223. 10.1016/j.clnu.2006.01.021CrossRefPubMed Kreymann KG, Berger MM, Deutz NE, Hiesmayr M, Jolliet P, Kazandjiev G, Nitenberg G, Berghe G, Wernerman J, DGEM (German Society for Nutritional Medicine), Ebner C, Hartl W, Heymann C, Spies C, ESPEN (European Society for Parenteral and Enteral Nutrition): ESPEN guidelines on enteral nutrition: intensive care. Clin Nutr 2006, 25: 210-223. 10.1016/j.clnu.2006.01.021CrossRefPubMed
3.
go back to reference Villet S, Chiolero RL, Bollmann MD, Revelly JP, Cayeux R, N MC, Delarue J, Berger MM: Negative impact of hypocaloric feeding and energy balance on clinical outcome in ICU patients. Clin Nutr 2005, 24: 502-509. 10.1016/j.clnu.2005.03.006CrossRefPubMed Villet S, Chiolero RL, Bollmann MD, Revelly JP, Cayeux R, N MC, Delarue J, Berger MM: Negative impact of hypocaloric feeding and energy balance on clinical outcome in ICU patients. Clin Nutr 2005, 24: 502-509. 10.1016/j.clnu.2005.03.006CrossRefPubMed
4.
go back to reference Dvir D, Cohen J, Singer P: Computerized energy balance and complications in critically ill patients: an observational study. Clin Nutr 2006, 25: 37-44. 10.1016/j.clnu.2005.10.010CrossRefPubMed Dvir D, Cohen J, Singer P: Computerized energy balance and complications in critically ill patients: an observational study. Clin Nutr 2006, 25: 37-44. 10.1016/j.clnu.2005.10.010CrossRefPubMed
5.
go back to reference Singer P, Berger MM, Berghe G, Biolo G, Calder P, Forbes A, Griffiths R, Kreyman G, Leverve X, Pichard C: ESPEN guidelines for parenteral nutrition: intensive care. Clin Nutr 2009, 28: 387-400. 10.1016/j.clnu.2009.04.024CrossRefPubMed Singer P, Berger MM, Berghe G, Biolo G, Calder P, Forbes A, Griffiths R, Kreyman G, Leverve X, Pichard C: ESPEN guidelines for parenteral nutrition: intensive care. Clin Nutr 2009, 28: 387-400. 10.1016/j.clnu.2009.04.024CrossRefPubMed
6.
go back to reference McClave SA, Martindale RG, Vanek VW, McCarthy M, Roberts P, Taylor B, Ochoa JB, Napolitano L, Cresci G, A.S.P.E.N. Board of Directors; American College of Critical Care Medicine; Society of Critical Care Medicine: 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 (ASPEN). JPEN J Parenter Enteral Nutr 2009, 33: 277-316. 10.1177/0148607109335234CrossRefPubMed McClave SA, Martindale RG, Vanek VW, McCarthy M, Roberts P, Taylor B, Ochoa JB, Napolitano L, Cresci G, A.S.P.E.N. Board of Directors; American College of Critical Care Medicine; Society of Critical Care Medicine: 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 (ASPEN). JPEN J Parenter Enteral Nutr 2009, 33: 277-316. 10.1177/0148607109335234CrossRefPubMed
7.
go back to reference Martin CM, Doig GS, Heyland DK, Morrison T, Sibbald WJ: Multi-centre, cluster randomized clinical trial of algorithms for critical-care enteral and parenteral therapy (ACCEPT). CMAJ 2004, 170: 197-204.PubMedCentralPubMed Martin CM, Doig GS, Heyland DK, Morrison T, Sibbald WJ: Multi-centre, cluster randomized clinical trial of algorithms for critical-care enteral and parenteral therapy (ACCEPT). CMAJ 2004, 170: 197-204.PubMedCentralPubMed
8.
go back to reference Doig GS, Simpson F, Finfer S, Delaney A, Mitchell I, Gobb G: Effects of evidence based feeding guidelines on mortality of critically ill patients. A cluster randomized controlled trial. JAMA 2008, 300: 2731-2741. 10.1001/jama.2008.826CrossRefPubMed Doig GS, Simpson F, Finfer S, Delaney A, Mitchell I, Gobb G: Effects of evidence based feeding guidelines on mortality of critically ill patients. A cluster randomized controlled trial. JAMA 2008, 300: 2731-2741. 10.1001/jama.2008.826CrossRefPubMed
9.
go back to reference McCowen KC, Friel C, Sternberg J, Chan S, Forse RA, Burke PA, Bistrian BR: Hypocaloric total parenteral nutrition: effectiveness in prevention of hyperglycemia and infectious complications: a randomized clinical trial. Crit Care Med 2000, 28: 3606-3611. 10.1097/00003246-200011000-00007CrossRefPubMed McCowen KC, Friel C, Sternberg J, Chan S, Forse RA, Burke PA, Bistrian BR: Hypocaloric total parenteral nutrition: effectiveness in prevention of hyperglycemia and infectious complications: a randomized clinical trial. Crit Care Med 2000, 28: 3606-3611. 10.1097/00003246-200011000-00007CrossRefPubMed
10.
go back to reference Choban PS, Burge JC, Scales D, Flancbaum L: Hypoenergetic nutrition support in hospitalized obese patients: a simplified method for clinical application. Am J Clin Nutr 1997, 66: 546-550.PubMed Choban PS, Burge JC, Scales D, Flancbaum L: Hypoenergetic nutrition support in hospitalized obese patients: a simplified method for clinical application. Am J Clin Nutr 1997, 66: 546-550.PubMed
11.
go back to reference Dickerson RN: Hypocaloric feeding of obese patients in the intensive care unit. Curr Opin Clin Nutr Metab Care 2005, 8: 189-196.CrossRefPubMed Dickerson RN: Hypocaloric feeding of obese patients in the intensive care unit. Curr Opin Clin Nutr Metab Care 2005, 8: 189-196.CrossRefPubMed
12.
go back to reference Bartlett RH, Dechert RE, Mault JR, Ferguson SK, Kaiser AM, Erlandson EE: Measurement of metabolism in multiple organ failure. Surgery 1982, 92: 771-779.PubMed Bartlett RH, Dechert RE, Mault JR, Ferguson SK, Kaiser AM, Erlandson EE: Measurement of metabolism in multiple organ failure. Surgery 1982, 92: 771-779.PubMed
13.
go back to reference Jeschke MG, Mlcak RP, Finnerty CC, Norbury WB, Przkora R, Kulp GA, Gauglitz GG, Zhang XJ, Herndon DN: Gender differences in pediatric burn patients: does it make a difference? Ann Surg 2008, 248: 126-36. 10.1097/SLA.0b013e318176c4b3CrossRefPubMed Jeschke MG, Mlcak RP, Finnerty CC, Norbury WB, Przkora R, Kulp GA, Gauglitz GG, Zhang XJ, Herndon DN: Gender differences in pediatric burn patients: does it make a difference? Ann Surg 2008, 248: 126-36. 10.1097/SLA.0b013e318176c4b3CrossRefPubMed
14.
go back to reference Combes A, Luyt CE, Trouillet JL, Nieszkowska A, Chastre J: Gender impact on the outcomes of critically ill patients with nosocomial infections. Crit Care Med 2009, 37: 2506-2511. 10.1097/CCM.0b013e3181a569dfCrossRefPubMed Combes A, Luyt CE, Trouillet JL, Nieszkowska A, Chastre J: Gender impact on the outcomes of critically ill patients with nosocomial infections. Crit Care Med 2009, 37: 2506-2511. 10.1097/CCM.0b013e3181a569dfCrossRefPubMed
15.
go back to reference Forse RA, Elwyn DH, Askanazi J, Iles M, Schwarz Y, Kinney JM: Effects of glucose on nitrogen balance during high nitrogen intake in malnourished patients. Clin Sci (Lond) 1990, 78: 273-281.CrossRef Forse RA, Elwyn DH, Askanazi J, Iles M, Schwarz Y, Kinney JM: Effects of glucose on nitrogen balance during high nitrogen intake in malnourished patients. Clin Sci (Lond) 1990, 78: 273-281.CrossRef
Metadata
Title
Toward protein-energy goal-oriented therapy?
Author
Pierre Singer
Publication date
01-10-2009
Publisher
BioMed Central
Published in
Critical Care / Issue 5/2009
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc8042

Other articles of this Issue 5/2009

Critical Care 5/2009 Go to the issue