TY - JOUR
T1 - Timing of parenteral nutrition in ICU patients
T2 - A transatlantic controversy
AU - Veraar, Cecilia
AU - Geilen, Johannes
AU - Fischer, Arabella
AU - Sulz, Isabella
AU - Tarantino, Silvia
AU - Mouhieddine, Mohamed
AU - Mora, Bruno
AU - Schuh, Christian
AU - Singer, Pierre
AU - Hiesmayr, Michael J.
N1 - Publisher Copyright:
© 2021 The Authors
PY - 2021/12
Y1 - 2021/12
N2 - 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.
AB - 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.
KW - Energy targets
KW - Guidelines on clinical nutrition
KW - NutritionDay
KW - Preferable route of administration of artificial nutrition
KW - Timing of parenteral nutrition
UR - http://www.scopus.com/inward/record.url?scp=85118827094&partnerID=8YFLogxK
U2 - 10.1016/j.clnesp.2021.08.007
DO - 10.1016/j.clnesp.2021.08.007
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C2 - 34857246
AN - SCOPUS:85118827094
SN - 2405-4577
VL - 46
SP - 532
EP - 538
JO - Clinical Nutrition ESPEN
JF - Clinical Nutrition ESPEN
ER -