First international meeting of early career investigators: Current opportunities, challenges and horizon in critical care nutrition research. (December 2020)

• Record Type: Journal Article
• Authors: Stoppe, Christian; van Gassel, Robert; Jonckheer, Joop; Garcia Velasquez, Maria Eloisa; Di Girolamo, Filippo Giorgio; Chapela, Sebastian Pablo; Wichansawakun, Sanit; Albay, Albert; Friede, Tim; Martindale, Robert; Berger, Mette M.
• Is Part Of: Clinical nutrition ESPEN. Volume 40(2020)
• Page Start: 92
• Page End: 100
• Publication Date: 2020-12
• Subjects: Parenteral nutrition -- Enteral nutrition -- Critical care -- Intensive care -- Nutritional support; EE energy expenditure -- EN enteral nutrition -- HCP healthcare provider -- ICU intensive care unit -- MNA Mini Nutritional Assessment (MNA) -- MST Malnutrition Screening Tool -- MUST Malnutrition Universal Screening Tool -- NRS-2002 Nutrition Risk Screening -- PN parenteral nutrition -- RCT randomized controlled trial -- SGA Subjective Global Assessment -- SNAQ Short Nutritional Assessment Questionnaire; Nutritionally induced diseases -- Periodicals; Metabolism -- Disorders -- Periodicals; 616.39005
• DOI: 10.1016/j.clnesp.2020.09.006
• Languages: English
• ISSNs: 2405-4577

Abstract

Summary: Background: Appropriate nutritional support is a key component of care for critically ill patients. While malnutrition increases complications, impacting long term outcomes and healthcare-related costs, uncertainties persist regarding optimal provision of nutritional support in this setting. Methods: An international group of healthcare providers (HCPs) from critical care specialties and nutrition researchers convened to identify knowledge gaps and learnings from studies in critical care nutrition. Clinical research needs were identified in order to better inform future nutrition practices. Results: Challenges in critical care nutrition arise, in part, from inconsistent outcomes in several large-scale studies regarding the optimal amount of calories and protein to prescribe, the optimal time to initiate nutritional support and the role of parental nutrition to support critically ill patients. Furthermore, there is uncertainty on how best to identify patients at nutritional risk, and the appropriate outcome measures for ICU nutrition studies. Given HCPs have a suboptimal evidence base to inform the nutritional management of critically ill patients, further well-designed clinical trials capturing clinically relevant endpoints are needed to address these knowledge gaps. Conclusions: The identified aspects for future research could be addressed in studies designed and conducted in collaboration with an international team of interdisciplinary nutrition experts. The aim of this collaboration is to address the unmet need for robust clinical data needed to develop high-quality evidence-based nutritional intervention recommendations to better inform the future management of critically ill patients. Highlights: Critical care nutrition knowledge gaps arise from limited studies of varying quality. Robust data are needed to better inform ICU nutritional support practices. Timing and composition of nutrition interventions, and role of PN need further in depth investigations. International research network is proposed to facilitate future high quality studies.