Featured Research

from universities, journals, and other organizations

Intravenous nutrition in critically ill patients should be delayed, study finds

Date:
June 7, 2011
Source:
The Endocrine Society
Summary:
Patients in the intensive care unit who do not tolerate adequate nutrition from tube feeding should wait a week before receiving intravenous (IV) feeding because, compared with early IV feeding, it enhances recovery from critical illness, according to results of a new multicenter study from Belgium.

Patients in the intensive care unit who do not tolerate adequate nutrition from tube feeding should wait a week before receiving intravenous (IV) feeding because, compared with early IV feeding, it enhances recovery from critical illness. Results of a new multicenter study from Belgium are being presented at The Endocrine Society's 93rd Annual Meeting in Boston.

"These findings have enormous impact for improving quality and reducing the cost of medical care for critically ill patients," said the study's principal investigator, Greet Van den Berghe, MD, PhD, a professor at the Catholic University of Leuven.

Results of this large randomized, controlled clinical trial contradict European clinical guidelines on IV nutritional support in ICU patients, and lend support to American and Canadian recommendations. Van den Berghe said, "The standard of care in Europe should change."

At issue is the optimal timing to initiate parenteral nutrition (PN), also called IV feeding, in critically ill patients who are not getting enough calories through the gut by enteral nutrition, or tube feeding. To avoid ICU patients becoming weak from nutritional deficit, European experts recommend that they begin PN within two days of admission to the ICU, Van den Berghe explained. However, PN is linked to an increased frequency and severity of hyperglycemia, or high blood sugar. Experts in the U.S. and Canada advise withholding PN during the first week in the ICU if patients were not malnourished before admission.

"Until now there has been no good scientific evidence to support either of the widely implemented nutritional strategies in intensive care," she said.

This study, called the EPaNIC trial for Early Parenteral Nutrition to supplement insufficient enteral nutrition in Intensive Care patients, compared the timing of PN initiation in adults at seven ICUs in Belgium who were at risk of malnutrition. Of the 4,640 participants, 2,312 patients were randomly assigned to receive "early" PN (within 48 hours of admission), and 2,328 received "late" PN (no earlier than day 8 in the ICU). Both groups received early enteral nutrition support and insulin to target normal blood sugar levels.

The researchers found that late PN was superior to early PN, with time in the ICU a median of one day shorter. "Withholding IV nutrition for one week in the ICU, even in patients who could not be fed at all via the normal enteral route, surprisingly accelerated alive discharge from the ICU and from the hospital, without threatening their ability to function," Van den Berghe said.

Late PN also lowered the frequency of complications compared with early PN, including reducing severe infections (22.8 versus 26.2 percent, respectively), the authors reported. Also, late PN shortened the time on a ventilator and on dialysis, "thus allowing faster recovery from organ failure," and it "prevented liver function abnormalities," Van den Berghe said.

The investigator-initiated study received funding from the Fund for Scientific Research in Flanders, Belgium, the Catholic University of Leuven (GOA), and the Methusalem program from the Flemish government in Belgium. A nonrestricted grant to the Catholic University of Leuven came from Baxter Healthcare in France.


Story Source:

The above story is based on materials provided by The Endocrine Society. Note: Materials may be edited for content and length.


Cite This Page:

The Endocrine Society. "Intravenous nutrition in critically ill patients should be delayed, study finds." ScienceDaily. ScienceDaily, 7 June 2011. <www.sciencedaily.com/releases/2011/06/110606142354.htm>.
The Endocrine Society. (2011, June 7). Intravenous nutrition in critically ill patients should be delayed, study finds. ScienceDaily. Retrieved August 22, 2014 from www.sciencedaily.com/releases/2011/06/110606142354.htm
The Endocrine Society. "Intravenous nutrition in critically ill patients should be delayed, study finds." ScienceDaily. www.sciencedaily.com/releases/2011/06/110606142354.htm (accessed August 22, 2014).

Share This




More Health & Medicine News

Friday, August 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Newsy (Aug. 21, 2014) An experimental drug used to treat Marburg virus in rhesus monkeys could give new insight into a similar treatment for Ebola. Video provided by Newsy
Powered by NewsLook.com
Cadavers, a Teen, and a Medical School Dream

Cadavers, a Teen, and a Medical School Dream

AP (Aug. 21, 2014) Contains graphic content. He's only 17. But Johntrell Bowles has wanted to be a doctor from a young age, despite the odds against him. He was recently the youngest participant in a cadaver program at the Indiana University NW medical school. (Aug. 21) Video provided by AP
Powered by NewsLook.com
American Ebola Patients Released: What Cured Them?

American Ebola Patients Released: What Cured Them?

Newsy (Aug. 21, 2014) It's unclear whether the American Ebola patients' recoveries can be attributed to an experimental drug or early detection and good medical care. Video provided by Newsy
Powered by NewsLook.com
Lost Brain Cells To Blame For Sleep Problems Among Seniors

Lost Brain Cells To Blame For Sleep Problems Among Seniors

Newsy (Aug. 21, 2014) According to a new study, elderly people might have trouble sleeping because of the loss of a certain group of neurons in the brain. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins