{"id":16998,"date":"2012-02-03T15:57:00","date_gmt":"2012-02-03T23:57:00","guid":{"rendered":"https:\/\/library.consciencelaws.org\/?p=16998"},"modified":"2023-02-10T16:08:05","modified_gmt":"2023-02-11T00:08:05","slug":"best-evidence-in-critical-care-medicine-early-versus-late-parenteral-nutrition-in-the-adult-icu-feeding-the-patient-or-our-conscience","status":"publish","type":"post","link":"https:\/\/library.consciencelaws.org\/?p=16998","title":{"rendered":"Best evidence in critical care medicine. Early versus late parenteral nutrition in the adult ICU: feeding the patient or our conscience?"},"content":{"rendered":"\n<h4 class=\"wp-block-heading\">Jeff P Kerrie,  Sean M Bagshaw, Peter G Brindley<\/h4>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"173\" height=\"230\" src=\"https:\/\/library.consciencelaws.org\/wp-content\/uploads\/2023\/02\/canjanesthesia.jpg\" alt=\"Canadian Journal of Anesthesia\" class=\"wp-image-17106\"\/><figcaption class=\"wp-element-caption\">Canadian Journal of Anesthesia<\/figcaption><\/figure>\n<\/div>\n\n\n<p><strong>Abstract<br>Background: <\/strong>Critical illness increases the risk of malnutrition, which can increase infections, prolong mechanical ventilation, delay recovery, and increase mortality. While enteral nutrition (EN) is considered optimal, this is not always an option. Furthermore, algorithms for parenteral nutrition (PN) vary significantly, and it is unclear whether early initiation or delay of parenteral feeding is preferable.<\/p>\n\n\n\n<p><strong>Objective: <\/strong>This study compares intensive care unit (ICU) duration of stay in adults randomized to early initiation of PN (within 48 hr of ICU admission) vs delayed (at eight days or later after ICU admission), as consistent with European and North American guidelines, respectively. . . .<\/p>\n\n\n\n<p><strong>Conclusions:<\/strong> While ICU and 90-day survival were not significantly different, patients in the late PN group were discharged earlier from both the ICU and the hospital. Late PN initiation was also associated with fewer infections, shorter mechanical ventilation time, shorter RRT time, and lower overall healthcare costs. While there were more episodes of hypoglycemia and more inflammation in the late PN group, there was no apparent clinical consequence. No primary or secondary end points showed that early PN was superior.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p>Kerrie JP, Bagshaw SM, Brindley PG. <a href=\"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12630-012-9674-z.pdf\">Best evidence in critical care medicine. Early versus late parenteral nutrition in the adult ICU: feeding the patient or our conscience? <\/a>Can J Anesthesia. 2012 Feb 03;59(5):494-498. <\/p>\n","protected":false},"excerpt":{"rendered":"<p>Jeff P Kerrie, Sean M Bagshaw, Peter G Brindley AbstractBackground: Critical illness increases the risk of malnutrition, which can increase infections, prolong mechanical ventilation, delay recovery, and increase mortality. While enteral nutrition (EN) is considered optimal, this is not always an option. Furthermore, algorithms for parenteral nutrition (PN) vary significantly, and it is unclear whether &hellip; <a href=\"https:\/\/library.consciencelaws.org\/?p=16998\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Best evidence in critical care medicine. Early versus late parenteral nutrition in the adult ICU: feeding the patient or our conscience?&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1824,1337,2],"tags":[1909,1911,1910],"post_folder":[],"class_list":["post-16998","post","type-post","status-publish","format-standard","hentry","category-artificial-nutrition-hydration","category-intensive-care","category-journal-article","tag-jeff-p-kerrie","tag-peter-g-brindley","tag-sean-m-bagshaw"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\r\n<title>Best evidence in critical care medicine. 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Early versus late parenteral nutrition in the adult ICU: feeding the patient or our conscience? - Protection of Conscience Project Library\" \/>\r\n<meta property=\"og:description\" content=\"ICU &amp; 90-day survival were not significantly different, but late parenteral nutrition patients were discharged earlier from ICU and hospital.\" \/>\r\n<meta property=\"og:url\" content=\"https:\/\/library.consciencelaws.org\/?p=16998\" \/>\r\n<meta property=\"og:site_name\" content=\"Protection of Conscience Project Library\" \/>\r\n<meta property=\"article:publisher\" content=\"https:\/\/www.youtube.com\/user\/consciencepro\" \/>\r\n<meta property=\"article:published_time\" content=\"2012-02-03T23:57:00+00:00\" \/>\r\n<meta property=\"article:modified_time\" content=\"2023-02-11T00:08:05+00:00\" \/>\r\n<meta property=\"og:image\" content=\"https:\/\/library.consciencelaws.org\/wp-content\/uploads\/2023\/02\/canjanesthesiaog.jpg\" \/>\r\n\t<meta property=\"og:image:width\" content=\"600\" \/>\r\n\t<meta property=\"og:image:height\" content=\"338\" \/>\r\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\r\n<meta name=\"author\" content=\"Project Administrator\" \/>\r\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\r\n<meta name=\"twitter:image\" content=\"https:\/\/library.consciencelaws.org\/wp-content\/uploads\/2023\/02\/canjanesthesiaog.jpg\" \/>\r\n<meta name=\"twitter:creator\" content=\"@consciencpro\" \/>\r\n<meta name=\"twitter:site\" content=\"@consciencpro\" \/>\r\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Project Administrator\" \/>\n\t<meta name=\"twitter:label2\" content=\"Estimated reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\r\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/library.consciencelaws.org\\\/?p=16998#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/library.consciencelaws.org\\\/?p=16998\"},\"author\":{\"name\":\"Project Administrator\",\"@id\":\"https:\\\/\\\/library.consciencelaws.org\\\/#\\\/schema\\\/person\\\/263d102b35e3f7822db6d548b2555098\"},\"headline\":\"Best evidence in critical care medicine. 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