Optimal energy provision early in ICU stay for critically ill patients receiving parenteral nutrition

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A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition

Published on: September 20, 2019

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Ahmed Nagy1,2, Justin Delic2, James M Hollands1,2

  • 1Philadelphia College of Pharmacy, Saint Joseph's University, Philadelphia, Pennsylvania, USA.

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
|September 22, 2023
PubMed

Insights

Optimal parenteral nutrition (PN) in critically ill patients remains unclear. This study found no significant difference in outcomes between lower and higher calorie provision via PN after adjusting for confounders.

Area of Science:

  • Critical Care Medicine
  • Nutritional Support
  • Clinical Nutrition

Background:

  • Evidence on optimal energy delivery via parenteral nutrition (PN) in critically ill patients is limited and of low quality.
  • Determining appropriate caloric intake is crucial for patient outcomes in the intensive care unit (ICU).

Purpose of the Study:

  • To investigate the impact of lower versus higher calorie provision via PN on mortality and other outcomes in adult critically ill patients.
  • To address the knowledge gap regarding optimal energy targets in early ICU PN administration.

Main Methods:

  • Retrospective study of 133 adult patients receiving PN within 10 days of ICU admission.
  • Comparison of outcomes between a lower calorie group (<20 kcal/kg/day) and a higher calorie group (>25 kcal/kg/day).
  • Primary outcome: all-cause, in-hospital mortality. Secondary outcomes: hospital/ICU length of stay, complication incidence.

Main Results:

  • Higher calorie PN group showed lower initial in-hospital mortality (17.86%) compared to the lower calorie group (36.36%; P=0.02).
  • Multivariate analysis revealed no significant difference in mortality at hospital discharge based on calorie provision.
  • No significant differences were observed in secondary outcomes between the groups.

Conclusions:

  • Early PN with lower versus higher calorie provision did not result in different outcomes in critically ill adults after controlling for confounders.
  • Further large-scale prospective studies are warranted to establish optimal caloric targets for PN in this patient population.
Abstract

Keywords:
critical illnessenergy requirementsintensive care unitparenteral nutrition

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