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Nutritional support in sepsis: when less may be more.

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Early nutritional support in sepsis shows limited evidence, prompting a review of permissive underfeeding. This approach may offer benefits, highlighting the need for trials on delayed nutrition during sepsis.

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Area of Science:

  • Critical care medicine
  • Nutritional science
  • Sepsis research

Background:

  • Current guidelines for nutritional support in sepsis lack strong evidence.
  • Existing recommendations from ESPEN and ASPEN are underwhelming.
  • There's a perceived low efficacy of nutritional support in sepsis management.

Purpose of the Study:

  • To review the clinically relevant benefits of permissive underfeeding in sepsis.
  • To motivate high-quality clinical trials on permissive underfeeding.
  • To investigate the benefits of delaying nutritional support during sepsis.

Main Methods:

  • Literature review of existing studies on nutritional support in sepsis.
  • Analysis of evidence supporting permissive underfeeding.
  • Identification of research gaps in sepsis nutrition trials.

Main Results:

  • Permissive underfeeding may offer clinically relevant benefits in sepsis.
  • A lack of high-quality trials hinders definitive conclusions on sepsis nutrition.
  • Evidence suggests a need to re-evaluate early nutritional support strategies.

Conclusions:

  • Urgent need for high-quality clinical trials on permissive underfeeding in sepsis.
  • Delaying nutritional support warrants further investigation for potential benefits.
  • Revisiting sepsis nutrition guidelines based on new evidence is crucial.