Hogeschool van Amsterdam

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The intensive care medicine research agenda in nutrition and metabolism

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PURPOSE: The objectives of this review are to summarize the current practices and major recent advances in critical care nutrition and metabolism, review common beliefs that have been contradicted by recent trials, highlight key remaining areas of uncertainty, and suggest recommendations for the top 10 studies/trials to be done in the next 10 years. METHODS: Recent literature was reviewed and developments and knowledge gaps were summarized. The panel identified candidate topics for future trials in critical care nutrition and metabolism. Then, members of the panel rated each one of the topics using a grading system (0-4). Potential studies were ranked on the basis of average score. RESULTS: Recent randomized controlled trials (RCTs) have challenged several concepts, including the notion that energy expenditure must be met universally in all critically ill patients during the acute phase of critical illness, the routine monitoring of gastric residual volume, and the value of immune-modulating nutrition. The optimal protein dose combined with standardized active and passive mobilization during the acute phase and post-acute phase of critical illness were the top ranked studies for the next 10 years. Nutritional assessment, nutritional strategies in critically obese patients, and the effects of continuous versus intermittent enteral nutrition were also among the highest-ranking studies. CONCLUSIONS: Priorities for clinical research in the field of nutritional management of critically ill patients were suggested, with the prospect that different nutritional interventions targeted to the appropriate patient population will be examined for their effect on facilitating recovery and improving survival in adequately powered and properly designed studies, probably in conjunction with physical activity.

Reference Arabi, Y. M., Casaer, M. P., Chapman, M., Heyland, D. K., Ichai, C., Marik, P. E., Martindale, R. G., McClave, S. A., Preiser, J-C., Reignier, J., Rice, T. W., Van den Berghe, G., van Zanten, A. R. H., & Weijs, P. J. M. (2017). The intensive care medicine research agenda in nutrition and metabolism. Intensive Care Medicine, 43(9), 1239-1256. https://doi.org/10.1007/s00134-017-4711-6
Published by  Faculty Sports and Nutrition 1 September 2017

Publication date

Sep 2017

Author(s)

Yaseen M Arabi
Michael P Casaer
Marianne Chapman
Daren K Heyland
Carole Ichai
Paul E Marik
Robert G Martindale
Stephen A McClave
Jean-Charles Preiser
Jean Reignier
Todd W Rice
Greet Van den Berghe
Arthur R H van Zanten
Michael P. Casaer
Daren K. Heyland
Paul E. Marik
Robert G. Martindale
Stephen A. McClave
Todd W. Rice
Arthur R. H. van Zanten

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