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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.
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“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
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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.
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“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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“28 Further awareness of nutrition management may lead to better prognoses in patients receiving PN. Previous studies have shown that insufficient energy intake did not affect clinical outcomes 29–31 and early achievement of energy goal increased complications 32 in critically ill patients.”
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“In which way does that help us improve clinical practice? Should we not ask about the nature of the patient populations studied in these trials? Were these patients malnourished? Was there any nutritional risk involved? Another approach has been to compare early with late nutritional intervention, by means of suppleme…”
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“In this context, randomized trials have shown that higher nutritional support did not benefit critically ill patients and was associated with higher morbidity [42, 43].”
BackgroundMicrobiome changes under enteral deprivation are dynamic and dependent on intestinal location
Bar‐Yoseph, H., Metcalfe‐Roach, A., Cirstea, M. S., & Finlay, B. B. (2024) · Journal of Parenteral and Enteral Nutrition · doi:10.1002/jpen.2624 · Cited by 6
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“A randomized trial by Casaer et al. [32] reported that the risk of diarrhea was higher with postpyloric feeding compared to parenteral nutrition (risk ratio 1.71, 95% CI 1.04–2.79).”
BackgroundInfluentialAnabolic Strategies for ICU-Acquired Weakness. What Can We Learn from Bodybuilders?
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“Delaying parenteral nutrition until the first week of ICU admission has been shown to promote rapid recovery with fewer complications [28,29].”
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“Various randomized controlled trials and meta-analyses have reported reductions in infection rates [5], medical costs [6], length of stay in the intensive care unit (ICU) [7], and number of days on mechanical ventilation [8] associated with EN alone or EN and parenteral nutrition together [9–11].”
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“These divergent data between the Swiss and the EPaNIC studies correspond to different practices, especially for the adjustment to energy expenditure [10,13].”
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A prospective study of energy and protein intakes in critically ill patients
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“The administration of complementary PN from the first three days of ICU stay reduced the incidence of infections, though no differences in patient mortality were observed versus late complementary PN, and mortality likewise did not depend on whether the patients reached the nutritional objective from day four or day 9…”
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“Finally, if patients cannot tolerate enteral feeds, the EPaniC trial suggests the addition of parenteral feeds could cause harm if given too early [23].”
BackgroundSchneeweiss-Gleixner, M., Scheiner, B., Semmler, G., Maleczek, M., Laxar, D., Hintersteininger, M., Hermann, M., Hermann, A., Buchtele, N., Schaden, E., et al. (2023) · Nutrients · doi:10.3390/nu15092098 · Cited by 6
“ICU patients are considered a high-risk population for undernutrition, making medical nutrition therapy an important component of intensive care treatment [35,36].”
BackgroundGao, X.-J., Zhang, L., Zhang, Y.-P., Zhou, D., Gao, T.-T., Liu, Y., Jin, G., Wang, K.-H., Zhou, Y.-B., Chi, Q., et al. (2023) · International Journal of Surgery · doi:10.1097/js9.0000000000000526 · Cited by 7
“The EPaNIC trial compared the prognosis of critically ill patients receiving SPN either late (initiated 8 days after ICU admission) or early (within 2 days) and concluded that early PN was harmful([34]), although tight glycemic protocol was provided to all patients.”
MethodFrom Mitochondrial Disturbances to Energy Requirements
Singer, P. (2012) · World review of nutrition and dietetics · doi:10.1159/000341247 · Cited by 6
Sonneville, R., den Hertog, H. M., Derde, S., Güiza, F., Derese, I., den Berghe, G. V., & Vanhorebeek, I. (2013) · Clinical Nutrition · doi:10.1016/j.clnu.2013.01.003 · Cited by 6
Basics in Clinical Medical Nutrition
Meier, R. F., & Forbes, A. (2015) · Nestlé Nutrition Institute Workshop series · doi:10.1159/000381997 · Cited by 6
Some Concerns About the Design of Nutrition Support Trials
Bistrian, B. R. (2016) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607116637939 · Cited by 6
Lighthall, G. K., & Olejniczak, M. J. (2015) · Seminars in Cardiothoracic and Vascular Anesthesia · doi:10.1177/1089253215584993 · Cited by 6
Enteral versus parenteral nutrition for adults in the intensive care unit
Lewis, S. R., Butler, A. R., Alderson, P., & Smith, A. F. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012276 · Cited by 6
den Berghe, G. V. (2016) · Clinical Nutrition · doi:10.1016/j.clnu.2016.10.011 · Cited by 6
Feeding the Critically Ill: More Questions Than Answers!
Marik, P. E., & Rice, T. W. (2017) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201609-1850ed · Cited by 6
Actualización en sepsis y choque séptico: nuevas definiciones y evaluación clínica
Arsanios, D. M., Barragán, A. F., Alfaro, D. G., Millán, F. C., Pinzón, J., Ramos-Isaza, E., & Muñoz, C. (2017) · Acta Colombiana de Cuidado Intensivo · doi:10.1016/j.acci.2017.03.001 · Cited by 8
Al‐Dorzi, H. M., Al‐Dawood, A., Tamim, H., Haddad, S. H., Jones, G., McIntyre, L., Solaiman, O., Sakhija, M., Sadat, M., Afesh, L. Y., et al. (2018) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2018.10.012 · Cited by 7
Shah, S., Hollands, J. M., Pontiggia, L., & Bingham, A. L. (2019) · Nutrition and Metabolic Insights · doi:10.1177/1178638819859315 · Cited by 7
“The median duration (interquartile range [IQR]) of PN was 8 (5-13) days and 98% received central PN.”
BackgroundKofler, M., Beer, R., Marinoni, S., Schiefecker, A. J., Gaasch, M., Rass, V., Lindner, A., Lanosi, B. A., Rhomberg, P., Pfausler, B., et al. (2022) · PLoS ONE · doi:10.1371/journal.pone.0265729 · Cited by 6
“…with a reduced length of ICU stay, less infectious complications and a shorter duration of mechanical ventilation compared to the early initiation (after 3 days) [12], however, the applicability of these findings in clinical routine and different patient populations has been questioned [13].”
Is there a role for ketones as alternative fuel in critical illness?
Watson, N., McClelland, T. J., & Puthucheary, Z. (2023) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000001061 · Cited by 6
“In adults, late parenteral nutrition reduced the incidence of ICU-acquired weakness and accelerated recovery hereof [61].”
BackgroundInfluentialde Assis, M. C. S., Silveira, C. R. D. M., Beghetto, M. G., & de Mello, E. D. (2016) · Revista de Nutrição · doi:10.1590/1678-98652016000300001 · Cited by 6
How to Feed the Critically Ill—A Review
Lew, C. C. H., Ong, C., Mukhopadhyay, A., Marshall, A. P., & Arabi, Y. M. (2020) · Annals of the Academy of Medicine Singapore · doi:10.47102/annals-acadmedsg.202064 · Cited by 6
Imaging opens possibilities both to target and to evaluate nutrition in critical illness
Rooyackers, O., & Wernerman, J. (2014) · Critical Care · doi:10.1186/cc13882 · Cited by 6
“Recently, a number of clinical trials have investigated the effect of nutrition in critical illness [1-4].”
BackgroundA liberal glycemic target in critically ill patients with poorly controlled diabetes?
Gunst, J., & den Berghe, G. V. (2016) · Annals of Translational Medicine · doi:10.21037/atm.2016.10.28 · Cited by 6
“In the Leuven studies on TGC, patients received early parenteral nutrition in accordance with European feeding guidelines, an approach that was subsequently shown to be harmful (16).”
Nutrition Support in Critically Ill Patients
Molavi, I., & Con, J. (2022) · Wiley eBooks · doi:10.1002/9781119756781.ch19 · Cited by 7
Reta-Pérez, O., Colmenero, M., Hernández-Socorro, C. R., Saavedra, P., Maichle, S., Portugal-Rodríguez, E., Cerezo-Arias, M., Sanchez-Ales, L., Martínez-Carmona, J. F., Mateu‐Campos, L., et al. (2024) · Nutrients · doi:10.3390/nu16091366 · Cited by 7
“…Prokinetics and parenteral nutrition (PN) were not to be used routinely, and their indication was at the discretion of the attending physician [22,34]. was at the discretion of the attending physician [22,34] A hyperproteic nutritional formula (10 g/100 mL) was used, with a caloric intake A…”
BackgroundMethodInfluentialChong, S. H., Huang, Y., Heng, M. S., Chong, E. S. T., Lim, C. D. Q., Wong, K. W., Chan, H. N., Heyland, D. K., Stoppe, C., Compher, C. W., et al. (2025) · Nutrition Reviews · doi:10.1093/nutrit/nuaf042 · Cited by 5
Wen, K.-L., Cao, Y., Du, H., Huang, W., & Zhang, A. (2025) · Scientific Reports · doi:10.1038/s41598-025-13738-1 · Cited by 5
“Previously, PN was regarded as harmful to critically ill patients, especially in terms of infectious complications 26,27 .”
The intensity of organ support: Restrictive or aggressive therapy for critically ill patients
Li, H., Li, Y., Fu, Y., Zhang, X., & Zhang, D. (2023) · Journal of Intensive Medicine · doi:10.1016/j.jointm.2023.04.002 · Cited by 5
O’Keefe, S. J., Graham, T. O., Coté, G. A., Whitcomb, D. C., Evans, A. C., & Soni, D. (2023) · Techniques and Innovations in Gastrointestinal Endoscopy · doi:10.1016/j.tige.2023.06.002 · Cited by 5
Nutrition Optimization Among Critically Ill Patients in the Cardiac Intensive Care Unit
Allaparthi, S., Bode, A., Bury, C., & Vest, A. R. (2025) · Current Cardiology Reports · doi:10.1007/s11886-025-02208-9 · Cited by 7
“However, it does not appear possible to prevent this energy mobilization by enhancing exogenous calorie delivery in the first few days of ICU admission and full nutritional support in the early phase of critical illness may be potentially harmful due to the risk of refeeding syndrome [7, 8].”
Zambuzzi, W. F., Ferreira, M. R., Wang, Z., & Peppelenbosch, M. P. (2025) · Biology · doi:10.3390/biology14060669 · Cited by 13
“In intensive care medicine, inducing ketosis by delaying parenteral calorie intake is associated with improved outcomes, both in adults [54] as well as children [55], even though not all studies fully recapitulated this result [56] and the results remained mixed.”
Stratégie d’optimisation multimodale et pluridisciplinaire de la nutrition en réanimation
Massanet, P. L., Morquin, D., Richard, C., Jonquet, O., & Corne, P. (2012) · Réanimation · doi:10.1007/s13546-012-0492-7 · Cited by 5
Nutrition Support in the Intensive Care Patient
DeLegge, M. H. (2013) · Journal of Infusion Nursing · doi:10.1097/nan.0b013e318297bfa2 · Cited by 5
Giving nutrition support to critically ill adults.
Fletcher, J. M. (2015) · PubMed · Cited by 5
van Schaik, R., Abeele, K. V. D., Melsens, G., Schepens, P., Lanssens, T., Vlaemynk, B., Devisch, M., & Niewold, T. (2016) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2016.07.002 · Cited by 5
Arabi, Y. M., Balwi, M. A. A., Hajeer, A. H., Jawdat, D. M., Sadat, M., Al‐Dorzi, H. M., Tamim, H., Afesh, L. Y., Almashaqbeh, W., Alkadi, H. S., et al. (2018) · Scientific Reports · doi:10.1038/s41598-018-36007-w · Cited by 5
“34 Duration of intervention (days) median (Q1, Q3) 13 (7, 14) 14 (8, 14) 0.”
Webbe, J., Longford, N. T., Uthaya, S. N., Modi, N., & Gale, C. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-029065 · Cited by 5
The Influence of Timing in Critical Care Nutrition
McKeever, L., Peterson, S. J., Lateef, O., & Braunschweig, C. A. (2021) · Annual Review of Nutrition · doi:10.1146/annurev-nutr-111120-114108 · Cited by 5
Nutritional Interventions on Physical Functioning for Critically Ill Patients: An Integrative Review
Zhou, W., Ruksakulpiwat, S., Fan, Y., & Ji, L. (2021) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s314132 · Cited by 6
Peri-operative nutrition in cardiovascular surgery: current pitfalls and future directions
Vinck, E., van Ierland, K. M., Rendon, J., Escobar, J. J., Quintero-Gomez, A., Saldarriaga, C., van Brakel, T. V., Klautz, R., & Cárdenas, D. (2021) · Acta Chirurgica Belgica · doi:10.1080/00015458.2021.2020009 · Cited by 5
“As a result, early enteral nutrition followed by delayed parenteral nutrition showed improved survival in the critically ill [26].”
BackgroundNovel nutritional strategies to prevent muscle wasting
McClelland, T. J., Davies, T., & Puthucheary, Z. (2023) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000001020 · Cited by 5
Zou, B., Xi, F., & Yu, W. (2023) · Annals of Translational Medicine · doi:10.21037/atm-22-6408 · Cited by 5
“The Early Parenteral Nutrition Completing Enteral Nutrition in Adult Critically Ill Patients (EPaNIC) study was conducted in patients whose caloric targets could not be met by EN alone (21).”
Three main components of initial enteral support for neurological patients in critical illness
Ershov, V. I., & Новикова, Т. В. (2023) · Russian Journal of Anesthesiology and Reanimatology · doi:10.17116/anaesthesiology202306184 · Cited by 5
Hermans, G., Mechelen, H. V., Clerckx, B., Vanhullenbusch, T., Mesotten, D., Wilmer, A., Casaer, M. P., Meersseman, P., Debaveye, Y. A., Wouters, P., et al. (2014) · Critical Care · doi:10.1186/cc13656 · Cited by 5
Self-citationGlycemic control in critically ill surgical patients: risks and benefits
May, A. K., Mukherjee, K., Albaugh, V. L., Richards, J. E., & Rumbaugh, K. A. (2015) · Open Access Surgery · doi:10.2147/oas.s50416 · Cited by 5
“This last design parameter is notable in light of recent evidence that early administration of parenteral nutrition may increase ICU mortality, the need for mechanical ventilation, and the rate of ICU infections.(74) Perhaps the most significant finding was the relationship between hyperglycemia, infection, multiple o…”
Muscle weakness and nutrition in critical illness: matching nutrient supply and use
Latronico, N., Nisoli, E., & Eikermann, M. (2013) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(13)70148-6 · Cited by 5
Influence of parenteral nutrition on blood rheology and platelet aggregation in vitro
Compagnoni, S. C., Schulzki, T., Thoeny, S., & Reinhart, W. H. (2014) · Biorheology · doi:10.3233/bir-140652 · Cited by 5
Nutrition Barriers in Abdominal Aortic Surgery
van Zanten, A. R. H. (2012) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607112464499 · Cited by 7
Lee, H., Chung, K. S., Park, M. S., Na, S., & Kim, Y. S. (2014) · Clinical Nutrition Research · doi:10.7762/cnr.2014.3.1.33 · Cited by 5
Kauffmann, R. M., Hayes, R. M., Laeken, A. H. V., Norris, P. R., Diaz, J. J., May, A. K., & Collier, B. R. (2014) · The American Surgeon · doi:10.1177/000313481408001125 · Cited by 5
Successive Phases of the Metabolic Response to Stress
Preiser, J., Ichaï, C., & Groeneveld, A. B. J. (2016) · Springer eBooks · doi:10.1007/978-3-319-27687-8_2 · Cited by 5
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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