Autophagy and Its Implications Against Early Full Nutrition Support in Critical Illness

Van Dyck, Lisa; Casaer, Michaël P.; Gunst, Jan

doi:10.1002/ncp.10084

Cited by 70Clinical Nutrition and GastroenterologyEnhanced Recovery After SurgeryAutophagy in Disease and Therapy

Autophagy and Its Implications Against Early Full Nutrition Support in Critical Illness

Van Dyck, Lisa, Casaer, Michaël P., Gunst, Jan·2018·Nutrition in Clinical Practice

DOI 10.1002/ncp.10084

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Abstract

The timing, dose, and route of early nutrition support in critically ill patients have been highly controversial for years. Despite the association of a caloric deficit with adverse outcome, several recent large, randomized, controlled trials have demonstrated a prolongation of organ failure and increased muscle weakness with increasing doses of nutrition in the acute phase of critical illness. A potential explanation for the negative impact of early, full feeding on outcome is feeding‐induced suppression of autophagy, a cellular repair process that is necessary to clear intracellular damage. Whether nutrition management in critically ill patients should be guided by its effects on autophagy is a topic of debate. Currently, however, autophagy cannot be monitored in clinical practice. Moreover, clinical management should be guided by high‐quality randomized controlled trials, which currently do not support the use of early full nutrition support.

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In the proinflammatory phase of acute trauma or infection, nutrition support may even delay healing due to potential interference with clearance of damage.
“In this circumstance, it is becoming likely that nutrition support may even delay healing due to potential interference with clearance of damage.150, 151, 152”
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Authors: Van Dyck, L., Casaer, M. P., & Gunst, J.
Affiliations: Laboratory of Intensive Care Medicine Department of Cellular and Molecular Medicine KU Leuven Belgium
Clinical Division and Laboratory of Intensive Care Medicine Department of Cellular and Molecular Medicine KU Leuven Belgium
KU Leuven (BE)
Corresponding author: Gunst, Jan
ORCID: Gunst, Jan
Venue: Nutrition in Clinical Practice
Publisher: Wiley
Published: 2018-04-17
Volume: 33
Issue: 3
Pages: 339-347
ISSN: 0884-5336 (ISSN-L)
1941-2452
DOI: 10.1002/ncp.10084
OpenAlex: W2801436383
Semantic Scholar: 2afca0235b4711a237f3b099cc4144f7b5da0b23
Cited by: 70
References: 72
Citations by year: 2026: 1 · 2025: 7 · 2024: 4 · 2023: 10 · 2022: 5 · 2021: 9 · 2020: 19 · 2019: 11 · 2018: 4
FWCI: 1.38
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Nutrition in Clinical Practice (publishedVersion)
PubMed (publishedVersion)
Lirias (submittedVersion)
Funders: Fonds Wetenschappelijk Onderzoek (1151018N, 1832817N)
KU Leuven (STG/16/021, C24/17/070)
Topics: Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
Health Sciences › Medicine › Epidemiology › Autophagy in Disease and Therapy
Keywords: autophagy, critical illness, intensive care nutrition, caloric deficit, organ failure, muscle weakness
MeSH terms: Autophagy, Critical Care, Enteral Nutrition, Humans, Intensive Care Units, Length of Stay, Nutritional Requirements, Parenteral Nutrition, Randomized Controlled Trials as Topic, Critical Illness

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Autophagy and Its Implications Against Early Full Nutrition Support in Critical Illness

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