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Implementing Early ICU Nutrition: Does it Change Outcomes? One-Minute Journal Club
22 views · Jun 3, 2022
Visit Channel: eddyjoemd.com
Show Notes: https://eddyjoemd.com/icu-nutrition/

This is a one-minute Journal Club-ish.
Check out the full free article for yourself as this is not medical advice.
Hat tip to the authors.
Nutrition in the critically ill is of utmost importance.
Part of the problem is that it is often overlooked.
The authors here attempted to implement evidence-based guidelines for nutrition.
They performed a multi center RCT including almost 1400 patients.
Table 1 shows their protocol.
The feeding guideline group received quicker initiation of nutrition.
Although the initiation in the control group was within 48 hours of enrollment as well.
Seems like the standard practice of the control group was pretty reasonable.
Although they were rather excited to start parenteral nutrition early.
There was no difference in the amount of calories between the two groups.
There was also no difference in how these were tolerated.
All in all, there was no difference in mortality at day 28.
There was no difference in getting out of the ICU sooner.
The authors stated that perhaps mortality as the wrong primary outcome.
How quickly do you start nutrition in your ICU?

Citation:
Ke L, Lin J, Doig GS, van Zanten ARH, Wang Y, Xing J, Zhang Z, Chen T, Zhou L, Jiang D, Shi Q, Lin J, Liu J, Cheng A, Liang Y, Gao P, Sun J, Liu W, Yang Z, Zhang R, Xing W, Zhang A, Zhou Z, Zhou T, Liu Y, Tong F, Wang Q, Pan A, Huang X, Fan C, Lu W, Shi D, Wang L, Li W, Gu L, Xie Y, Sun R, Guo F, Han L, Zhou L, Zheng X, Shan F, Liu J, Ai Y, Qu Y, Li L, Li H, Pan Z, Xu D, Zou Z, Gao Y, Yang C, Kou Q, Zhang X, Wu J, Qian C, Zhang W, Zhang M, Zong Y, Qin B, Zhang F, Zhai Z, Sun Y, Chang P, Yu B, Yu M, Yuan S, Deng Y, Zhao L, Zang B, Li Y, Zhou F, Chen X, Shao M, Wu W, Wu M, Zhang Z, Li Y, Guo Q, Wang Z, Gong Y, Song Y, Qian K, Feng Y, Fu B, Liu X, Li Z, Gong C, Sun C, Yu J, Tang Z, Huang L, Ma B, He Z, Zhou Q, Yu R, Tong Z, Li W; Chinese Critcal Care Nutrition Trials Group (CCCNTG). Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial. Crit Care. 2022 Feb 16;26(1):46. doi: 10.1186/s13054-022-03921-5. Erratum in: Crit Care. 2022 Apr 21;26(1):115. PMID: 35172856; PMCID: PMC8848648.
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