• Endogenous glucose production
• Enteral nutrition
• Gastric residual volume
• Gastrointestinal dysfunction
• Refeeding syndrome
• Target

• Humans
• Critical Care/methods
• Critical Care/standards
• Critical Illness/therapy
• Nutritional Support/methods
• Enteral Nutrition/methods
• Enteral Nutrition/standards

• Acute phase
• Calorie
• Critical illness
• Energy intake
• Mortality
• Nutrition therapy

• Humans
• Critical Illness/therapy
• Retrospective Studies
• Energy Intake
• Male
• Female
• Middle Aged
• Aged
• Intensive Care Units
• Nutritional Support
• Nutritional Requirements
• Nutritional Status
• Length of Stay
• Proportional Hazards Models
• Treatment Outcome
• Critical Care

• Humans
• Nutritional Support/methods
• Critical Illness/therapy
• Critical Illness/rehabilitation
• Intensive Care Units
• Critical Care/methods
• Nutritional Status
• Energy Intake
• Randomized Controlled Trials as Topic
• Dietary Proteins/administration & dosage
• Enteral Nutrition/methods

• acute gastrointestinal injury
• feeding intolerance
• nomograms
• nutritional support intensive care unit
• outcome

• Wu Jieping Medical Foundation

• Hospitalized patients
• Intensive care unit
• Kidney disease
• Kidney replacement therapy
• Malnutrition
• Medical Nutrition Therapy

• Humans
• Renal Insufficiency, Chronic/therapy
• Renal Insufficiency, Chronic/diet therapy
• Hospitalization
• Nutritional Status
• Renal Replacement Therapy/methods
• Renal Replacement Therapy/standards
• Nutritional Support/methods
• Nutritional Support/standards
• Nutrition Assessment
• Acute Kidney Injury/therapy
• Acute Kidney Injury/diet therapy
• Nutritional Requirements
• Nutrition Therapy/methods
• Nutrition Therapy/standards

• Critically
• Enteral nutrition
• Meta-analysis
• Systematic review
• Taurine

• Taurine/therapeutic use
• Humans
• Critical Illness/therapy
• Enteral Nutrition/methods
• Treatment Outcome
• Intensive Care Units
• Length of Stay
• Randomized Controlled Trials as Topic

• Humans
• Nutritional Support/methods
• Wounds and Injuries/surgery
• Wounds and Injuries/therapy
• Wounds and Injuries/complications
• Nutrition Assessment
• Nutritional Status
• General Surgery
• Acute Care Surgery

• acute respiratory failure
• enteral nutrition critically
• high-flow nasal oxygen therapy
• noninvasive ventilation
• nutrition support
• trophic feeding

• Humans
• Male
• Female
• Middle Aged
• Prospective Studies
• Aged
• Intensive Care Units
• Noninvasive Ventilation/methods
• Enteral Nutrition/methods
• Oxygen Inhalation Therapy/methods
• Spain
• Respiratory Insufficiency/therapy
• Respiratory Insufficiency/mortality
• Treatment Outcome
• Respiration, Artificial
• Logistic Models

• immunomodulation
• in vitro fertilization
• intralipid
• intravenous lipid emulsion
• recurrent pregnancy loss
• uterine natural killer cells

• ESPEN
• Enteral
• Guidelines
• Intensive care
• Nutrition
• Parenteral
• Recommendations

• Humans
• Parenteral Nutrition
• Intensive Care Units
• Nutritional Status
• Critical Illness/therapy

• abdominal surgery
• early achievement of energy target
• enteral nutrition alone
• nosocomial infection
• nutritional support strategy
• supplemental parenteral nutrition

• Humans
• Middle Aged
• Critical Illness
• Cross Infection/epidemiology
• Cross Infection/etiology
• Cross Infection/prevention & control
• Enteral Nutrition
• Length of Stay
• Nutritional Status
• Nutritional Support
• Postoperative Complications/epidemiology
• Postoperative Complications/etiology
• Postoperative Complications/prevention & control
• Randomized Controlled Trials as Topic
• Aged

• acute respiratory distress syndrome
• artificial nutrition
• metabolic support

• Immunometabolic paralysis
• Immunonutrition
• Ketogenic diet
• Macronutrients
• Microbiome

• Humans
• Enteral Nutrition
• Critical Illness/therapy
• Parenteral Nutrition
• Immunity
• Immunomodulation

• critical illness
• dna methylation
• epigenetics
• long-term outcome
• nutrition

• Child
• Humans
• Critical Illness/therapy
• Parenteral Nutrition/methods
• Epigenesis, Genetic
• Intensive Care Units
• DNA

• COVID-19
• SARS-CoV-2
• intensive care
• mechanical ventilation
• medical nutrition therapy
• nutrition support
• prone position

• critical illness
• mechanical ventilation
• mortality
• nutrition support
• parenteral nutrition

• Amino acid
• Autophagy
• Critical illness
• Energy target
• Enteral nutrition
• Indirect calorimetry
• Intermittent feeding
• Ketone
• Parenteral nutrition

Gastrointestinal and sensory manifestations (GSMs) of coronavirus disease 2019 (COVID‐19) may affect food intake, resulting in malnutrition and poor outcomes. We characterized the impact of GSMs and oral nutrition supplementation on energy‐protein intake (EPI) and hospital discharge in adult patients with COVID‐19.

Patients from two hospitals were enrolled (n = 357). We recorded the presence and type of GSM at admission, estimated energy requirements (EER) and the EPI based on regular food intake (plate diagram sheets) during hospital stays. Patients not achieving 60% of their EER from food over 2 consecutive days received oral nutrition supplementation (ONS) with a high‐energy‐protein oral drink.

Most patients (63.6%) presented with GSMs at admission. Anorexia was the most common manifestation (44%). Patients with anorexia or more than one GSMs were more likely to not achieve 60% EER on the first day of follow‐up and to require the ONS intervention (P ≤ 0.050). Prevalence of at least one GSM was higher in patients who did not achieve hospital discharge than in patients who achieved it (74.2% vs 54.6%, P = 0.038). The patients requiring ONS (26.9%) demonstrated good adherence to the intervention (79.3%), achieved their EER during 95.7% of the supplementation time, and presented with hospital discharge rates similar to patients not requiring ONS (92.2% vs 91.9%, respectively; P = 1.000).

GSM were prevalent in COVID‐19 and it impaired EER attendance and patient recovery. ONS was well‐tolerated, aided EER attendance, and potentially facilitated hospital discharge.

• COVID-19
• anorexia
• gastrointestinal symptoms
• nutrition therapy
• oral nutrition supplement

• National Natural Science Foundation of China

• C-reactive protein
• albumin
• intensive care unit
• prognosis
• stroke

The importance of enteral nutrition (EN) in acute pancreatitis (AP) has been emphasised. Nasogastric (NG) feeding has been the preferred route for EN delivery in most AP patients intolerant to oral intake. However, gastric feeding intolerance (GFI) was frequently reported, especially in patients with more severe diseases. This study aimed to investigate the incidence and risk factors for GFI in moderately-severe to severe AP.

This is a single-centre, retrospective study. All the data were extracted from an electronic database from April 2020 to May 2021. Data were prospectively collected during hospitalisation. Patients diagnosed with moderately-severe to severe AP and admitted within seven days from the onset of abdominal pain were assessed for eligibility. Patients who showed signs of intolerance to gastric feeding and required switching to nasojejunal (NJ) feeding were deemed GFI. Multivariable logistic regression was performed to assess potential risk factors of GFI.

A total of 93 patients were analysed, of whom 24 were deemed GFI (25.8%), and the rest tolerated NG feeding well (n = 69). In patients with GFI, the median time of switching to NJ feeding was five days (interquartile range: 4–7 days) after admission. The multivariable analysis showed that respiratory failure (odds ratio = 3.135, 95% CI: 1.111–8.848, P = 0.031) was an independent risk factor for GFI.The mean daily energy delivery in the following three days after switching to NJ feeding was significantly higher than the first three days after initiation of NG feeding in patients with GFI [920.83 (493.33–1326) vs. 465 (252.25–556.67) kcal, P < 0.001].

GFI is common in moderately-severe to severe AP patients with an incidence of 25.8%, and the presence of respiratory failure may increase the risk of GFI.

The online version contains supplementary material available at 10.1186/s12876-022-02403-w.

• Acute pancreatitis
• Enteral nutrition
• Feeding intolerance
• Jejunal feeding
• Prognosis

• Adult
• Critical Illness/therapy
• Enteral Nutrition/adverse effects
• Extracorporeal Membrane Oxygenation/adverse effects
• Humans
• Nutritional Status
• Respiratory Insufficiency/therapy

• calories
• extracorporeal life support
• extracorporeal membrane oxygenation
• indirect calorimetry
• micronutrients
• prone position
• protein

• Critical illness
• Intensive care unit
• Nutrition
• Underfeeding

The aim of the review was to analyse the challenges of using indirect calorimetry in patients with sepsis, including the limitations of this method. A systematic review of the literature was carried out. The analysis concerned the methodology and presentation of research results. In most studies assessing energy expenditure, energy expenditure was expressed in kcal per day (n = 9) and as the mean and standard deviation (n = 7). Most authors provided a detailed measurement protocol, including measurement duration (n = 10) and device calibration information (n = 7). Ten papers provided information on the day of hospitalisation when the measurements were obtained, nine on patient nutrition, and twelve on the criteria for inclusion and exclusion of participants from the study. Small study group sizes and study at a single centre were among the most cited limitations. Studies assessing energy expenditure in patients with sepsis by indirect calorimetry differ in the methodology and presentation of results, and their collective analysis is difficult. A meta-analysis of the results could enable multi-site and large patient evaluation. Standardisation of protocols and presentation of all collected data would enable their meta-analysis, which would help to achieve greater knowledge about metabolism in sepsis.

• calorimetry
• clinical nutrition
• critical care
• energy demand
• energy expenditure
• metabolism
• sepsis
• septic shock

• Adult
• Clinical Decision Rules
• Clinical Decision-Making/methods
• Critical Illness/therapy
• Humans
• Nutrition Therapy/standards
• Retrospective Studies
• Societies, Medical/standards
• Wounds and Injuries/diagnosis
• Wounds and Injuries/therapy

Survivors of critical illness requiring prolonged mechanical ventilation (PMV) are predisposed to malnutrition, muscle wasting, and weakness. There is a lack of data regarding nutrition adequacy among these patients, and although nitrogen balance has been studied as a marker of adequate protein intake in healthy individuals and acutely critically ill patients, it has not been well studied in critically ill patients with PMV. The purpose of this study was to determine if patients requiring PMV admitted to a long-term acute care hospital (LTACH) achieved registered dietitian (RD) recommended goals for energy and protein intake and if the recommendations were adequate to avoid negative nitrogen balance.

Using a retrospective, cohort study design, patients requiring PMV who had orders for 24-h urine collections for urea nitrogen (24hrUUN) were included. Energy and protein intake was calculated from chart documentation of dietary intake for the 24-h period during which patients underwent a 24hrUUN. Nitrogen intake was estimated from protein intake. Dietary intake was compared to RD-recommendations to determine the percentage of RD-recommendations achieved. Nitrogen balance was calculated as nitrogen intake minus nitrogen loss, with negative balance categorized as less than −1.

Subjects (n = 16) were 38% male and 75% African American (mean age 61.5 ± 3.2 years; mean BMI 27.5 ± 2.5 kg/m²). Duration of LTACH hospitalization was 26.5 (6–221) days. Mean energy and protein intake was 21.7 ± 2.9 kcal/kg/d and 1.1 ± 0.1 g/kg/d, respectively, which corresponded to 86% of both RD energy and protein recommendations. Ten patients achieved a positive nitrogen balance (mean 0.9 ± 1.1 g). In addition, there was a positive linear relationship between protein intake and nitrogen balance (r = 0.59, p = 0.016).

Survivors of critical illness requiring PMV achieved a high percentage of RD-recommended protein and calories, and prevented a negative nitrogen balance in a majority of patients. Increasing protein intake can prevent a negative nitrogen balance. Future studies should evaluate whether these patients are able to maintain a steady state of nitrogen intake and excretion over time and how this affects time to and/or success of weaning.

• Caloric intake
• Critical illness
• Mechanical ventilation
• Nutritional therapy

• Heart disease
• Indirect calorimetry
• Predictive equation
• Validity

• adult intensive & critical care
• intensive & critical care
• nutritional support

• Adult
• Airway Extubation
• Critical Illness
• Enteral Nutrition
• Humans
• Intensive Care Units
• Intubation, Intratracheal
• Randomized Controlled Trials as Topic

• Ministère des Affaires Sociales et de la Santé

Objective: Early enteral nutrition (EEN) represents the current standard of care for patients treated in general intensive care units (ICU). Specific nutritional recommendations for patients receiving dedicated neurocritical care are not established. This study investigated associations of EEN with clinical outcomes for patients suffering from intracerebral hemorrhage treated at a neurological ICU (NICU).

Methods: This retrospective cohort study included patients admitted to the NICU with atraumatic ICH over a 4-year period. Nutritional data, demographic, clinical, radiological, and laboratory characteristics were assessed. EEN was defined as any enteral nutrition within 48 hours after admission. Comparisons were undertaken for patients with EEN vs. those without, further propensity score (PS) matching (caliper 0.2; one: many) was used to account for baseline imbalances. Primary outcome was the modified Rankin Scale (0–3 = favorable, 4–6 = unfavorable) at 12 months, secondary outcomes comprised perihemorrhagic edema (PHE) volume, infectious complications during the hospital stay, and mRS at 3 months, as well as mortality rates at 3 and 12 months.

Results: Of 166 ICH-patients treated at the NICU, 51 (30.7%) patients received EEN, and 115 (69.3%) patients received no EEN (nEEN). After propensity score matching, calories delivered from enteral nutrition (EEN 161.4 [106.4–192.3] kcal/day vs. nEEN 0.0 [0.0–0.0], P < 0.001) and the total calories (EEN 190.0 [126.0–357.0] kcal/day vs. nEEN 33.6 [0.0–190.0] kcal/day, P < 0.001) were significantly different during the first 48 h admitted in NICU. Functional outcome at 12 months (mRS 4–6, EEN 33/43 [76.7%] vs. nEEN, 49/64 [76. 6%]; P = 1.00) was similar in the two groups. There were neither differences in mRS at 3 months, nor in mortality rates at 3 and 12 months between the two groups. EEN did not affect incidence of infective complications or gastrointestinal adverse events during the hospital stay; however, EEN was associated with significantly less extent of PHE evolution [maximum absolute PHE (OR 0.822, 95% CI 0.706–0.957, P = 0.012); maximum relative PHE (OR 0.784, 95% CI 0.646–0.952, P = 0.014)].

Conclusion: In our study, EEN was associated with reduced PHE in ICH-patients treated at a NICU. However, this observation did not translate into improved survival or functional outcome at 3 and 12 months.

• intracerebral hemorrhage
• neurological intensive care
• nutrition
• perihemorrhagic edema
• prognosis

• Energy expenditure
• Energy requirements
• Indirect calorimetry
• Nutritional prescriptions
• Predictive equations

• Aged
• Basal Metabolism
• Body Constitution
• Body Weight
• Calorimetry, Indirect
• Critical Illness
• Energy Intake
• Energy Metabolism
• Female
• Humans
• Male
• Neoplasms/physiopathology
• Nutrition Policy
• Nutritional Requirements
• Obesity/physiopathology
• Oxygen Consumption
• Surgical Procedures, Operative

• MR/P021220/1 Medical Research Council

• Acute kidney disease
• Acute kidney injury
• Clinical nutrition
• Enteral nutrition
• Hospitalized patients
• Intensive care unit
• Kidney replacement therapy
• Malnutrition
• Muscle wasting
• Parenteral nutrition

The objective of this study was to develop a new predictive equation of resting energy expenditure (REE) for acute kidney injury patients (AKI) on dialysis.

A cross-sectional descriptive study was carried out of 114 AKI patients, consecutively selected, on dialysis and mechanical ventilation, aged between 19 and 95 years. For construction of the predictive model, 80% of cases were randomly separated to training and 20% of unused cases to validation. Several machine learning models were tested in the training data: linear regression with stepwise, rpart, support vector machine with radial kernel, generalised boosting machine and random forest. The models were selected by ten-fold cross-validation and the performances evaluated by the root mean square error.

There were 364 indirect calorimetry measurements in 114 patients, mean age of 60.65 ± 16.9 years and 68.4% were males. The average REE was 2081 ± 645 kcal. REE was positively correlated with C-reactive protein, minute volume (MV), expiratory positive airway pressure, serum urea, body mass index and inversely with age. The principal variables included in the selected model were age, body mass index, use of vasopressors, expiratory positive airway pressure, MV, C-reactive protein, temperature and serum urea. The final r-value in the validation set was 0.69.

We propose a new predictive equation for estimating the REE of AKI patients on dialysis that uses a non-linear approach with better performance than actual models.

• Acute kidney injury
• Dialysis
• Energy metabolism
• Machine learning
• Resting energy expenditure
• Sepsis

• critical illness
• food intake
• nutrition rehabilitation
• oral nutrition
• quality of care

• Critical Care/standards
• Critical Illness/rehabilitation
• Energy Intake
• Humans
• Intensive Care Units
• Length of Stay
• Malnutrition/prevention & control
• Nutrition Assessment
• Nutritional Status
• Quality of Health Care/organization & administration

Omega-3 (ω-3) fatty acid (FA)-containing parenteral nutrition (PN) is associated with significant improvements in patient outcomes compared with standard PN regimens without ω-3 FA lipid emulsions. Here, we evaluate the impact of ω-3 FA-containing PN versus standard PN on clinical outcomes and costs in adult intensive care unit (ICU) patients using a meta-analysis and subsequent cost-effectiveness analysis from the perspective of a hospital operating in five European countries (France, Germany, Italy, Spain, UK) and the US.

We present a pharmacoeconomic simulation based on a systematic literature review with meta-analysis. Clinical outcomes and costs comparing ω-3 FA-containing PN with standard PN were evaluated in adult ICU patients eligible to receive PN covering at least 70% of their total energy requirements and in the subgroup of critically ill ICU patients (mean ICU stay > 48 h). The meta-analysis with the co-primary outcomes of infection rate and mortality rate was based on randomized controlled trial data retrieved via a systematic literature review; resulting efficacy data were subsequently employed in country-specific cost-effectiveness analyses.

In adult ICU patients, ω-3 FA-containing PN versus standard PN was associated with significant reductions in the relative risk (RR) of infection (RR 0.62; 95% CI 0.45, 0.86; p = 0.004), hospital length of stay (HLOS) (− 3.05 days; 95% CI − 5.03, − 1.07; p = 0.003) and ICU length of stay (LOS) (− 1.89 days; 95% CI − 3.33, − 0.45; p = 0.01). In critically ill ICU patients, ω-3 FA-containing PN was associated with similar reductions in infection rates (RR 0.65; 95% CI 0.46, 0.94; p = 0.02), HLOS (− 3.98 days; 95% CI − 6.90, − 1.06; p = 0.008) and ICU LOS (− 2.14 days; 95% CI − 3.89, − 0.40; p = 0.02). Overall hospital episode costs were reduced in all six countries using ω-3 FA-containing PN compared to standard PN, ranging from €-3156 ± 1404 in Spain to €-9586 ± 4157 in the US.

These analyses demonstrate that ω-3 FA-containing PN is associated with statistically and clinically significant improvement in patient outcomes. Its use is also predicted to yield cost savings compared to standard PN, rendering ω-3 FA-containing PN an attractive cost-saving alternative across different health care systems.

PROSPERO CRD42019129311.

• Cost-effectiveness
• Critically ill
• Intensive care
• Meta-analysis
• Omega-3 fatty acid
• Parenteral nutrition

• critical care
• nutrition
• oral intake
• protein deficit
• quality improvement

• Alcohol abuse
• Hypokalemia
• Hypomagnesemia
• Hypophosphatemia

• Assessment
• Mechanism
• Muscle wasting
• Treatment

• Critical Illness
• Humans
• Muscle, Skeletal/metabolism
• Muscular Atrophy/metabolism
• Muscular Atrophy/therapy
• Nutrition Therapy
• Signal Transduction/physiology
• Wasting Syndrome/metabolism
• Wasting Syndrome/therapy

Malnutrition results from a decrease or increase or imbalance of energy, protein and other nutrients, leading to measurable negative effects on body tissue, body shape, organ function and clinical status. Research shows that nutritional support is one of the necessary processes for survival of traumatic patient hospitalized at surgical intensive care unit. The purpose of this study is to evaluate the nutritional status of trauma patients hospitalized at surgical intensive care unit of Kowsar Hospital in Semnan, Iran. This cross-sectional descriptive study was performed on patients older than 18 years with head, neck and femur injuries. Initial data were collected using a checklist containing demographic information questions, designed from the Ministry of Health and Medical Education's Nutrition Screening Form, which was available in the Nutrition Assessment Forms and Guidelines for Hospitalized Patients Approved in 2013. The data were analyzed using Chi-square or Fisher's exact tests, paired t-test and Pearson coefficient. The confidence level was 95% and significance level was less than 0.05 in all tests. The amount of energy determined by the intensive care unit for the patients, with a significantly lower relationship than the amount of energy required by the patients for 24 hours, based on the Harris Benedict formula was (918.20±474.80 calories vs. 1535.76±243.73 calories, respectively and P-value˂0.001). The amount of protein determined by the intensive care unit for the patients for 24 hours, with a significantly relationship lower than the protein required for the patients for 24 hours, was (51.68±34.39 vs. 106.57±13.67, respectively, and P-value˂ 0.001). There was a statistically significant relationship between the age of the patients and energy (P˂0.001) and protein (P˂0.001) determined by the intensive care unit for the patients for 24 hours and energy (P˂0.001) and protein (P˂0.001) required for the patients for 24 hours. The results of this study showed that both the amount of energy and the amount of protein determined by the intensive care unit for trauma patients for less than 24 hours were lower than the required level; therefore, dietary modification for these patients is recommended.

• Intensive Care Unit
• Nutritional assessment
• trauma patient

• Harris–Benedict equations
• Henry equations
• Mifflin–St Jeor equations
• Owen equations
• Prediction equations
• RMR
• Schofield equations

• Adult
• Basal Metabolism
• Body Mass Index
• Calorimetry, Indirect/methods
• Female
• Humans
• Linear Models
• Middle Aged
• Nutritional Requirements
• Regression Analysis
• Young Adult