Clinical nutrition issues in 2022: What is missing to trust supplemental parenteral nutrition (SPN) in ICU patients?

• Autor(a) principal: Berger, Mette M.
• Data de Publicação: 2022
• Outros Autores: Burgos, Rosa, Casaer, Michael P., De Robertis, Edoardo, Delgado, Juan Carlos Lopez, Fraipont, Vincent, Gonçalves-Pereira, João, Pichard, Claude, Stoppe, Christian
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.26/44917
• topic: Clinical nutrition; Critically ill; Intensive care unit; Nutrition care; Supplemental parenteral nutrition

A multidisciplinary group of international physicians involved in the medical nutrition therapy (MNT) of adult critically ill patients met to discuss the value, role, and open questions regarding supplemental parenteral nutrition (SPN) along with oral or enteral nutrition (EN), particularly in the intensive care unit (ICU) setting. This manuscript summarizes the discussions and results to highlight the importance of SPN as part of a comprehensive approach to MNT in critically ill adults and for researchers to generate new evidence based on well-powered randomized controlled trials (RCTs). The experts agreed on several key points: SPN has shown clinical benefts, resulting in this strategy being included in American and European guidelines. Nevertheless, its use is heterogeneous across European countries, due to the persistence of uncertainties, such as the optimal timing and the risk of overfeeding in absence of indirect calorimetry (IC), which results in divergent opinions and barriers to SPN implementation. Education is also insufcient. The experts agreed on actions needed to increase evidence quality on SPN use in specifc patients at a given time point during acute critical illness or recovery.