The intensive care medicine research agenda in nutrition and metabolism

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, Peter J.M. Weijs

Research output: Contribution to journalReview article

72 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1239-1256
Number of pages18
JournalIntensive Care Medicine
Volume43
Issue number9
DOIs
StatePublished - Sep 1 2017

Keywords

  • Calorie
  • Critical care
  • Intensive care
  • Metabolism
  • Nutrition
  • Protein

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Fingerprint Dive into the research topics of 'The intensive care medicine research agenda in nutrition and metabolism'. Together they form a unique fingerprint.

  • Cite this

    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