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Early versus Late Parenteral Nutrition in Critically Ill Adults
Open accessAbstract
BACKGROUND: Controversy exists about the timing of the initiation of parenteral nutrition in critically ill adults in whom caloric targets cannot be met by enteral nutrition alone. METHODS: In this randomized, multicenter trial, we compared early initiation of parenteral nutrition (European guidelines) with late initiation (American and Canadian guidelines) in adults in the intensive care unit (ICU) to supplement insufficient enteral nutrition. In 2312 patients, parenteral nutrition was initiated within 48 hours after ICU admission (early-initiation group), whereas in 2328 patients, parenteral nutrition was not initiated before day 8 (late-initiation group). A protocol for the early initiation of enteral nutrition was applied to both groups, and insulin was infused to achieve normoglycemia. RESULTS: Patients in the late-initiation group had a relative increase of 6.3% in the likelihood of being discharged alive earlier from the ICU (hazard ratio, 1.06; 95% confidence interval [CI], 1.00 to 1.13; P=0.04) and from the hospital (hazard ratio, 1.06; 95% CI, 1.00 to 1.13; P=0.04), without evidence of decreased functional status at hospital discharge. Rates of death in the ICU and in the hospital and rates of survival at 90 days were similar in the two groups. Patients in the late-initiation group, as compared with the early-initiation group, had fewer ICU infections (22.8% vs. 26.2%, P=0.008) and a lower incidence of cholestasis (P<0.001). The late-initiation group had a relative reduction of 9.7% in the proportion of patients requiring more than 2 days of mechanical ventilation (P=0.006), a median reduction of 3 days in the duration of renal-replacement therapy (P=0.008), and a mean reduction in health care costs of €1,110 (about $1,600) (P=0.04). CONCLUSIONS: Late initiation of parenteral nutrition was associated with faster recovery and fewer complications, as compared with early initiation. (Funded by the Methusalem program of the Flemish government and others; EPaNIC ClinicalTrials.gov number, NCT00512122.).
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“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”
From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [150]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Late, as compared with early initiation of PN, was associated with lower mortality, less need for ventilation and renal support, shorter ICU and hospital stay, and fewer infectious complications [36].”
From Nutrition in Sepsis: A Bench-to-Bedside Review. (2020) · cites this paper as [36]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Casaer et al. (16) observed that early (supplemental or exclusive) PN is associated with increased morbidity including prolonged ICU dependency and mechanical ventilation, and increased infection rate and need for renal replacement therapy.”
From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [16]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In a sub-group analysis of the EPaNIC study, early and late PN was compared in complicated pulmonary/esophageal and abdomino-pelvic surgery patients.Reduced infection rates in late vs early PN were observed (29.9% vs. 40.2%,p=0.01) with no difference in any mortality outcomes, whereas all these patients received virtually no EN during the seven study days (16).”
From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [16]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Casaer et al. [14] observed that early (supplemental or exclusive) PN is associated with increased morbidity including prolonged ICU dependency and mechanical ventilation, and increased infection rate and need for renal replacement therapy.”
From ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit (2023) · cites this paper as [14]
Experimental — accuracy not yet measured
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In the citing paper
“Reduced infection rates in late vs early PN were observed (29.9% vs. 40.2%,p ¼ 0.01) with no difference in any mortality outcomes, whereas all these patients received virtually no EN during the seven study days [14].”
From ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit (2023) · cites this paper as [14]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Adding parenteral nutrition to enteral nutrition to increase intakes was associated with longer ICU stays and higher infection rates.13,14”
The cited source says what the claim attributes to it.
In the citing paper
“In the EpaNIC randomised trial of early versus late parenteral nutrition to supplement insufficient enteral intakes, mortality was similar in the two groups, but benefits in the late group included fewer ICU-acquired infections and shorter durations of mechanical ventilation, renal replacement therapy, and ICU stay.13”
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“the toleration of a nutritional deficit during the first week of critical illness resulted in fewer complications and accelerated recovery [91].”
From An update on non-thyroidal illness syndrome (2021) · cites this paper as [91]
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“In our trial, ICU-acquired infections were less common than in EpaNIC despite greater critical illness severity and higher mortality of patients, perhaps because all infections were adjudicated by an independent committee.”
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In the citing paper
“In previous randomised trials, nutritional interventions affected time to readiness for ICU discharge but not mortality.13,14”
The cited source says what the claim attributes to it.
In the citing paper
“A similar strategy regarding this endpoint has been used previously in studies on nutrition in the ICU.13,14”
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“However, results of this study revealed the potential harm of nutritional intervention aiming at full, possibly overestimated calorie targets during the acute phase of critical illness.”
From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [16]
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“This was also the conclusions of the EPaniC study including more than 1000 septic patients (16).”
From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [16]
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“Additionally, one study showed possible benefit of a further delay of PN if EN is not possible/tolerated in non-malnourished ICU patients (16).”
From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [16]
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“Additionally, one study showed possible benefit of a further delay of PN if EN is not possible/ tolerated [14].”
From ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit (2023) · cites this paper as [14]
The cited source says what the claim attributes to it.
In the citing paper
“However, results of this study revealed the potential harm of nutritional intervention aiming at full, possibly overestimated calorie targets during the acute phase of critical illness.”
From ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit (2023) · cites this paper as [14]
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“…and physicians worldwide, and late vs. early enteral and parenteral guidelines are desired for the treatment of the critically ill and injured (Casaer et al., 2011b), means based titrating blood [glucose] with insulin (Meijering et al., 2006) or standardized equations describing caloric needs…”
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“Finally, in a general ICU population from the multi-center randomized controlled EPaNIC trial [18], the AKIpredictor models [19] were developed, with advanced machine learning techniques, to predict AKI at different time points in the clinical course of the patient (before admission, upon…”
MethodSelf-citationProteins and amino acids are fundamental to optimal nutrition support in critically ill patients
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“Randomized trials have shown that the use of early PN did not improve mortality [123,129].”
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Tangvik, R., Tell, G., Guttormsen, A., Eisman, J., Henriksen, A., Nilsen, R. M., & Ranhoff, A. (2015) · Clinical Nutrition · doi:10.1016/j.clnu.2014.08.001 · Cited by 88
“The conclusion from the EPaNIC study [33] that the ICU patient benefits from less energy, at least i.”
BackgroundMethodInfluentialHegazi, R. A. F., & Wischmeyer, P. E. (2011) · Critical Care · doi:10.1186/cc10430 · Cited by 104
Metabolism, Metabolomics, and Nutritional Support of Patients with Sepsis
Englert, J. A., & Rogers, A. J. (2016) · Clinics in Chest Medicine · doi:10.1016/j.ccm.2016.01.011 · Cited by 102
“The late-initiation strategy was associatedwith faster recovery (6% increased likelihood of discharge alive from ICU and hospital) and fewer ICU infections.(69) The Early PN Trial randomized 1372 with short-term contraindications to enteral feeding to receive either early PN versus pragmatic standard care (of the latt…”
Nutritional-risk scoring systems in the intensive care unit
Kondrup, J. (2014) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0000000000000041 · Cited by 102
Acquired Muscle Weakness in the Surgical Intensive Care Unit
Farhan, H. N., Moreno‐Duarte, I., Latronico, N., ZAFONTE, R. D., & Eikermann, M. (2015) · Anesthesiology · doi:10.1097/aln.0000000000000874 · Cited by 104
LOGIC-Insulin Algorithm–Guided Versus Nurse-Directed Blood Glucose Control During Critical Illness
Herpe, T. V., Mesotten, D., Wouters, P. J., Herbots, J., Voets, E., Buyens, J., Moor, B. D., & den Berghe, G. V. (2012) · Diabetes Care · doi:10.2337/dc12-0584 · Cited by 97
Self-citationThe Japanese guidelines for the management of sepsis
Oda, S., Aibiki, M., Ikeda, T., Imaizumi, H., Endo, S., Ochiai, R., Kotani, J., Shime, N., Nishida, O., Noguchi, T., et al. (2014) · Journal of Intensive Care · doi:10.1186/s40560-014-0055-2 · Cited by 94
“and reduced health-care costs in the group started on supplemental parenteral nutrition from day 8 [210].”
BackgroundPremorbid obesity, but not nutrition, prevents critical illness‐induced muscle wasting and weakness
Goossens, C., Marques, M. B., Derde, S., Perre, S. V., Dufour, T., Thiessen, S., Güiza, F., Janssens, T., Hermans, G., Vanhorebeek, I., et al. (2016) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.12131 · Cited by 102
“Muscle weakness In fully cooperative patients, who were still in the ICU on day 8 ± 1, muscle strength was quantified with the MRC sum score.(13,28) To correct for a possible bias by an effect of the randomized intervention on ICU stay, a random sample of patients discharged from the ICU was assessed in the regular ho…”
BackgroundMethodSelf-citationSchetz, M., Gunst, J., & den Berghe, G. V. (2014) · Intensive Care Medicine · doi:10.1007/s00134-014-3487-1 · Cited by 93
“EPaNIC trial [23] comparing two nutritional strategies in”
Self-citationShort-term amino acid infusion improves protein balance in critically ill patients
Liebau, F., Sundström, M., van Loon, L. J. C., Wernerman, J., & Rooyackers, O. (2015) · Critical Care · doi:10.1186/s13054-015-0844-6 · Cited by 93
“There is also evidence that overfeeding, or even any feeding, during the initial week of an ICU stay might extend ICU stay [13].”
BackgroundHermans, G., Aerde, N. V., Meersseman, P., Mechelen, H. V., Debaveye, Y. A., Wilmer, A. P., Gunst, J., Casaer, M. P., Dubois, J., Wouters, P. J., et al. (2019) · Thorax · doi:10.1136/thoraxjnl-2018-213020 · Cited by 102
Self-citationHepatic PPARα is critical in the metabolic adaptation to sepsis
Paumelle, R., Haas, J. T., Hennuyer, N., Baugé, E., Deleye, Y., Mesotten, D., Langouche, L., Vanhoutte, J., Cudejko, C., Wouters, K., et al. (2019) · Journal of Hepatology · doi:10.1016/j.jhep.2018.12.037 · Cited by 93
“parenteral nutrition [4], have shown some promise, suggesting that appropriate adaptation of”
BackgroundSelf-citation2017 Update on Medical Overuse
Morgan, D. J., Dhruva, S. S., Coon, E. R., Wright, S. M., & Korenstein, D. R. (2017) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2017.4361 · Cited by 91
Harvey, S. E., Parrott, F., Harrison, D. A., Sadique, Z., Grieve, R., Canter, R. R., McLennan, B. K., Tan, J. C., Bear, D. E., Segaran, E., et al. (2016) · Health Technology Assessment · doi:10.3310/hta20280 · Cited by 94
“EQ-5D-5L component Parenteral group (N= 467) Enteral group (N= 473) Mobility No problems 166 (36) 172 (37) Slight problems 93 (20) 90 (19) Moderate problems 114 (24) 99 (21) Severe problems 65 (20) 80 (17) Extreme problems 29 (6) 32 (7) Self-care No problems 280 (61) 287 (61) Slight problems 87 (19) 71 (15) Moderate p…”
Hypoxic liver injury and cholestasis in critically ill patients
Horvatits, T., Trauner, M. A., & Fuhrmann, V. (2013) · Current Opinion in Critical Care · doi:10.1097/mcc.0b013e32835ec9e6 · Cited by 89
Jäger, B., Drolz, A., Michl, B., Schellongowski, P., Bojic, A., Nikfardjam, M., Zauner, C., Heinz, G., Trauner, M. A., & Fuhrmann, V. (2012) · Hepatology · doi:10.1002/hep.25896 · Cited by 89
Egi, M., Ogura, H., Yatabe, T., Atagi, K., Inoue, S., Iba, T., Kakihana, Y., Kawasaki, T., Kushimoto, S., Kuroda, Y., et al. (2021) · Acute Medicine & Surgery · doi:10.1002/ams2.659 · Cited by 88
Frailty in Pulmonary and Critical Care Medicine
Singer, J. P., Lederer, D. J., & Baldwin, M. R. (2016) · Annals of the American Thoracic Society · doi:10.1513/annalsats.201512-833fr · Cited by 89
Acute-on-chronic liver failure (ACLF): the ‘Kyoto Consensus’—steps from Asia
Choudhury, A. K., Kulkarni, A. V., Arora, V., Soin, A. S., Dökmeci, A. K., Chowdhury, A., Koshy, A., Duseja, A. K., Kumar, A., Mishra, A. K., et al. (2025) · Hepatology International · doi:10.1007/s12072-024-10773-4 · Cited by 98
Gunst, J., De Bruyn, A., & Van den Berghe, G. (2019) · Current Opinion in Anaesthesiology · doi:10.1097/aco.0000000000000706 · Cited by 84
Nutrition in the intensive care unit: from the acute phase to beyond
de Man, A., Gunst, J., & Blaser, A. R. (2024) · Intensive Care Medicine · doi:10.1007/s00134-024-07458-9 · Cited by 102
“The first RCT that challenged the assumption that early full nutrition would be beneficial was the EPaNIC RCT, published in 2011 [5].”
BackgroundInfluentialSepsis and Septic Shock Strategies
Armstrong, B., Betzold, R., & May, A. K. (2017) · Surgical Clinics of North America · doi:10.1016/j.suc.2017.07.003 · Cited by 88
Enteral nutrient deprivation in patients leads to a loss of intestinal epithelial barrier function
Ralls, M. W., Demehri, F. R., Feng, Y., Ignatoski, K. M. W., & Teitelbaum, D. H. (2015) · Surgery · doi:10.1016/j.surg.2014.12.004 · Cited by 84
“Even though hard evidence of a decrease in EBF in humans is lacking, the detrimental impact of the loss of EBF has been well-described.(6,8,18,30,31) In the present work, we posited that enteric nutrient deprivation leads to loss of EBF in human small bowel.”
BackgroundInfluentialMetabolic support in the critically ill: a consensus of 19
Wernerman, J., Christopher, K. B., Annane, D., Casaer, M. P., Coopersmith, C. M., Deane, A. M., Waele, E. D., Elke, G., Ichaï, C., Karvellas, C. J., et al. (2019) · Critical Care · doi:10.1186/s13054-019-2597-0 · Cited by 85
“(EPaNIC) [20] and children (PEPaNIC) [21].”
Self-citationNonthyroidal Illness Syndrome Across the Ages
Langouche, L., Jacobs, A., & den Berghe, G. V. (2019) · Journal of the Endocrine Society · doi:10.1210/js.2019-00325 · Cited by 85
“More recently, two large RCTs in adults and in children demonstrated that tolerating a nutritional deficit during the first week of critical illness as compared with the early administration of supplemental parenteral nutrition resulted in fewer complications and accelerated recovery [89, 90].”
BackgroundBraunschweig, C. A., Sheean, P. M., Peterson, S. J., Gomez Perez, S., Freels, S., Troy, K. L., Ajanaku, F. C., Patel, A., Sclamberg, J. S., & Wang, Z. (2014) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607113500505 · Cited by 81
Fivez, T., Kerklaan, D., Verbruggen, S. C. A. T., Vanhorebeek, I., Verstraete, S., Tibboel, D., Guerra, G. G., Wouters, P. J., Joffe, A. R., Joosten, K., et al. (2015) · Trials · doi:10.1186/s13063-015-0728-8 · Cited by 80
“A recent randomized controlled trial (RCT) in critically ill adults [19] showed that the early provision of PN worsened rather than improved outcomes as compared with withholding PN and thus tolerating a substantial caloric deficit up to 1 week in ICU.”
BackgroundMethodSelf-citationDoes artificial nutrition improve outcome of critical illness?
Schetz, M., Casaer, M. P., & den Berghe, G. V. (2012) · Critical Care · doi:10.1186/cc11828 · Cited by 80
Self-citationLangouche, L., Vander Perre, S., Marques, M., Boelen, A., Wouters, P. J., Casaer, M. P., & Van den Berghe, G. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-2809 · Cited by 79
Self-citationNutrition Support for Persistent Inflammation, Immunosuppression, and Catabolism Syndrome
Moore, F. A., Phillips, S. M., McClain, C. J., Patel, J. J., & Martindale, R. G. (2017) · Nutrition in Clinical Practice · doi:10.1177/0884533616687502 · Cited by 79
“Recently, a PRT demonstrated worse outcomes with early supplemental PN, and the investigators proposed that early high protein nutrition support was harmful because of inhibition of autophagy.(16) While this is an interesting hypothesis, it is unproven, and other recent data refute this concern.”
BackgroundLoss of appetite in acutely ill medical inpatients: physiological response or therapeutic target?
Schütz, P., Bally, M., Stanga, Z., & Keller, U. (2014) · Swiss Medical Weekly · doi:10.4414/smw.2014.13957 · Cited by 78
Umpierrez, G. E., Spiegelman, R., Zhao, V., Smiley, D. D., Pinzon, I., Griffith, D. P., Peng, L., Morris, T., Luo, M., Garcia, H., et al. (2012) · Critical Care Medicine · doi:10.1097/ccm.0b013e3182474bf9 · Cited by 77
Dysglycaemia in the critically ill – significance and management
Deane, A. M., & Horowitz, M. (2013) · Diabetes Obesity and Metabolism · doi:10.1111/dom.12078 · Cited by 78
Sepsis: frontiers in supportive care, organisation and research
Perner, A., Rhodes, A., Venkatesh, B., Angus, D. C., Martín‐Loeches, I., Preiser, J., Vincent, J., Marshall, J. C., Reinhart, K., Joannidis, M., et al. (2017) · Intensive Care Medicine · doi:10.1007/s00134-017-4677-4 · Cited by 77
Nishida, O., Ogura, H., Egi, M., Fujishima, S., Hayashi, Y., Iba, T., Imaizumi, H., Inoue, S., Kakihana, Y., Kotani, J., et al. (2018) · Acute Medicine & Surgery · doi:10.1002/ams2.322 · Cited by 78
Toward nutrition improving outcome of critically ill patients: How to interpret recent feeding RCTs?
Gunst, J., Casaer, M. P., Preiser, J., Reignier, J., & den Berghe, G. V. (2023) · Critical Care · doi:10.1186/s13054-023-04317-9 · Cited by 80
“Also in the large EPaNIC subgroup of patients for whom enteral nutrition was contraindicated (N = 517), early total parenteral nutrition was harmful as compared to virtual starvation for one week in ICU [11].”
BackgroundSelf-citationPeake, S. L., Davies, A. R., Deane, A. M., Lange, K., Moran, J. L., O’Connor, S. N., Ridley, E. J., Williams, P. J., & Chapman, M. J. (2014) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.114.086322 · Cited by 71
“In an attempt to increase calorie delivery, many strategies have been tried with limited success, including promotility drugs (10, 11), small intestinal catheters (12), aggressive nutrition protocols (7), and supplemental intravenous nutrition (13).”
BackgroundThe anabolic role of the Warburg, Cori-cycle and Crabtree effects in health and disease
Soeters, P. B., Shenkin, A., Sobotka, L., Soeters, M. R., de Leeuw, P. W., & Wolfe, R. R. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2021.02.012 · Cited by 78
Severe sepsis and septic shock
Schorr, C., Zanotti, S. L., & Dellinger, R. P. (2013) · Virulence · doi:10.4161/viru.27409 · Cited by 78
Role of Glucagon in Catabolism and Muscle Wasting of Critical Illness and Modulation by Nutrition
Thiessen, S. E., Derde, S., Derese, I., Dufour, T., Vega, C. A., Langouche, L., Goossens, C., Peersman, N., Vermeersch, P., Vander Perre, S., et al. (2017) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201702-0354oc · Cited by 75
Self-citationDGEM-Leitlinie: „Klinische Ernährung in der Intensivmedizin“
Elke, G., Hartl, W. H., Kreymann, K. G., Adolph, M., Felbinger, T. W., Graf, T., de Heer, G., Heller, A. R., Kampa, U., Mayer, K., et al. (2018) · Aktuelle Ernährungsmedizin · doi:10.1055/a-0713-8179 · Cited by 78
Impaired gastrointestinal transit and its associated morbidity in the intensive care unit
Nguyen, T. T., Frenette, A.-J., Johanson, C., MacLean, R. D., Patel, R. V., Simpson, A., Singh, A., Balchin, K., Fergusson, D. A., & Kanji, S. (2013) · Journal of Critical Care · doi:10.1016/j.jcrc.2012.12.003 · Cited by 74
The clinical evaluation of the new indirect calorimeter developed by the ICALIC project
Oshima, T., Delsoglio, M., Dupertuis, Y. M., Singer, P., Waele, E. D., Veraar, C., Heidegger, C., Wernermann, J., Wischmeyer, P. E., Berger, M. M., et al. (2020) · Clinical Nutrition · doi:10.1016/j.clnu.2020.01.017 · Cited by 72
Reignier, J., Darmon, M., Sonneville, R., Borel, A., Garrouste-Orgeas, M., Ruckly, S., Souweine, B., Dumenil, A.-S., Haouache, H., Adrie, C., et al. (2015) · Intensive Care Medicine · doi:10.1007/s00134-015-3730-4 · Cited by 75
“Two randomised trials focussing on the best time for starting supplemental PN in patients intolerant to EN yielded conflicting results [22, 32].”
InfluentialGlucose homeostasis, nutrition and infections during critical illness
Ingels, C., Vanhorebeek, I., & den Berghe, G. V. (2017) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2016.12.033 · Cited by 73
Self-citationThe Japanese clinical practice guideline for acute kidney injury 2016
Doi, K., Nishida, O., Shigematsu, T., Sadahiro, T., Itami, N., Iseki, K., Yuzawa, Y., Okada, H., Koya, D., Kiyomoto, H., et al. (2018) · Clinical and Experimental Nephrology · doi:10.1007/s10157-018-1600-4 · Cited by 73
Alsharif, D. J., Alsharif, F. J., Aljuraiban, G. S., & Abulmeaty, M. M. A. (2020) · Nutrients · doi:10.3390/nu12102968 · Cited by 71
“For example, in one study that included in both the analyses, the Early versus Late Parenteral Nutrition in Critically ill adults (EPaNIC) study, early PN administration (within the first day of ICU admission) was associated with an increased risk of nosocomial infections as well as longer durations of mechanical vent…”
BackgroundResultInfluentialIntensive care unit acquired weakness and physical rehabilitation in the ICU
Hiser, S. L., Casey, K. S., Nydahl, P., Hodgson, C. L., & Needham, D. M. (2025) · BMJ · doi:10.1136/bmj-2023-077292 · Cited by 78
“The initial screening should occur as early as possible after admission to ICU, within 24 hours if feasible.””
InfluentialHeyland, D. K., Day, A. G., Clarke, G., Hough, C. L., Files, D. C., Mourtzakis, M., Deutz, N. E. P., Needham, D. M., & Stapleton, R. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-027893 · Cited by 73
Metadata
- Authors
- Casaer, M. P., Mesotten, D., Hermans, G., Wouters, P. J., Schetz, M., Meyfroidt, G., Van Cromphaut, S., Ingels, C., Meersseman, P., Muller, J., Vlasselaers, D., Debaveye, Y., Desmet, L., Dubois, J., Van Assche, A., Vanderheyden, S., Wilmer, A., & Van den Berghe, G.
- Affiliations
- KU Leuven (BE)
- Jessa Hospital (BE)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2011-08-11
- Volume
- 365
- Issue
- 6
- Pages
- 506-517
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2162310928
- Semantic Scholar
- 43f68b96b74375a705c7271a7c056f6279b2a02c
- Cited by
- 1,696
- References
- 63
- Citations by year
- 2026: 85 · 2025: 102 · 2024: 99 · 2023: 77 · 2022: 82 · 2021: 111 · 2020: 119 · 2019: 107 · 2018: 101 · 2017: 123 · 2016: 115 · 2015: 154 · 2014: 162 · 2013: 135 · 2012: 93
- FWCI
- 122.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Lirias (submittedVersion)
- Funders
- Fonds Wetenschappelijk Onderzoek
- Vlaamse regering
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Keywords
- parenteral nutrition, timing of parenteral nutrition initiation, critically ill adults, intensive care unit, enteral nutrition, insulin infusion, normoglycemia, intensive care unit discharge, hospital discharge, cholestasis, mechanical ventilation duration, renal replacement therapy, health care costs, functional status
- MeSH terms
- Adult, Aged, Energy Intake, Enteral Nutrition, Female, Humans, Infections, Inflammation, Intensive Care Units, Length of Stay, Male, Middle Aged, Parenteral Nutrition, Prospective Studies, Time Factors, Critical Illness, Practice Guidelines as Topic, Kaplan-Meier Estimate
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