Timing of parenteral nutrition in ICU patients: A transatlantic controversy

Cecilia Veraar, Johannes Geilen, Arabella Fischer, Isabella Sulz, Silvia Tarantino, Mohamed Mouhieddine, Bruno Mora, Christian Schuh, Pierre Singer, Michael J. Hiesmayr*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Background and aims: European and North American guidelines on Parenteral Nutrition (PN) and large Randomized Controlled Trials give divergent advices on nutritional therapeutic strategies for critically ill patients. We therefore investigated differences in therapeutic strategies of clinicians between European and Non-European Intensive Care Units (ICU) regarding start day of PN, preferred route of administration and prescription of total energy targets over the years. Methods: In this study 16,032 patients from 1389 different ICUs were included. Data collection was performed in 28 different European and Non-European ICUs from 2007 to 2018 via nutritionDay, a worldwide-standardized one-day multinational cross-sectional audit. Results: In this analysis an abrupt delay in PN start days was observed in 2011 (7.64 days (4.31; 19.97); p = 0.001) and 2012 (6.41 days (3.1; 9.72); p = 0.001), which was significantly reversed within the following years until 2018. In European, compared to Non-European countries PN prescription was increased (27% versus 13%). Patients from North-America received significantly less kcal per day compared to Europe (−4.3 kcal kg−1 (−6.9; −1.6); p = 0.001). Conclusions: Our study provides further evidence on transatlantic discrepancies in nutritional therapy of ICU patients. Regular audits, such as nutritionDay are substantial for self-reflection of clinical daily practice of intensivists. It is time for worldwide consensus in nutritional therapy by developing worldwide guidelines and supporting standardization in nutrition care of critically ill patients.

Original languageEnglish
Pages (from-to)532-538
Number of pages7
JournalClinical Nutrition ESPEN
Volume46
DOIs
StatePublished - Dec 2021

Funding

FundersFunder number
Medizinische Universität Wien
European Society for Clinical Nutrition and Metabolism

    Keywords

    • Energy targets
    • Guidelines on clinical nutrition
    • NutritionDay
    • Preferable route of administration of artificial nutrition
    • Timing of parenteral nutrition

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