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Ann Clin Nutr Metab : Annals of Clinical Nutrition and Metabolism

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Guideline
Nutritional support for critically ill patients by the Korean Society for Parenteral and Enteral Nutrition — part I: a clinical practice guideline
Seung Hwan Lee, Jae Gil Lee, Min Kwan Kwon, Jiyeon Kim, Mina Kim, Jeongyun Park, Jee Young Lee, Ye Won Sung, Bomi Kim, Seong Eun Kim, Ji Yoon Cho, A Young Lim, In Gyu Kwon, Miyoung Choi, KSPEN Guideline Committee
Ann Clin Nutr Metab 2024;16(3):89-111.   Published online December 1, 2024
DOI: https://doi.org/10.15747/ACNM.2024.16.3.89
AbstractAbstract PDFSupplementary Material
Purpose: Nutritional support for adult critically ill patients is essential due to the high risk of malnutrition, which can lead to severe complications. This paper aims to develop evidence-based guidelines to optimize nutritional support in intensive care units (ICUs).
Methods: The Grading Recommendations, Assessment, Development and Evaluation process was used to develop and summarize the evidence on which the recommendations were based. Clinical outcomes were assessed for seven key questions.
Results: We recommend the following: (1) initiate enteral nutrition (EN) within 48 hours after treatment as it is associated with improved outcomes, including reduced infection rates and shorter ICU stays; (2) early EN is preferred over early parenteral nutrition due to better clinical outcomes; (3) the use of supplementary parenteral nutrition to meet energy targets during the first week of ICU admission in patients receiving early EN is conditionally recommended based on patient-specific needs; (4) limited caloric support should be supplied to prevent overfeeding and related complications, particularly in the early phase of critical illness; (5) higher protein intake is suggested to improve clinical outcomes, such as muscle preservation and overall recovery; (6) additional enteral or parenteral glutamine is conditionally recommended against due to the lack of significant benefit and potential harm; and (7) fish oil-containing lipid emulsions is conditionally recommended due to their potential to enhance clinical outcomes, including reduced infection rates and shorter ICU stays.
Conclusion: These evidence-based recommendations can improve clinical outcomes and support healthcare providers in making informed decisions about nutritional interventions in the ICU.
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Pneumothorax due to malpositioned nasogastric enteral feeding tube
Hyebeen Kim, Suk-Kyung Hong
Ann Clin Nutr Metab 2024;16(2):87-88.   Published online August 1, 2024
DOI: https://doi.org/10.15747/ACNM.2024.16.2.87
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Review Articles
Current Guidelines on Clinical Nutrition in Intensive Care Units Based on ESPEN 2018
Ahron Lee, Eun-Mee Kim, Chimin Park, Mi-Young Rha
J Clin Nutr 2019;11(2):31-37.   Published online December 31, 2019
DOI: https://doi.org/10.15747/jcn.2019.11.2.31
AbstractAbstract PDF

As the significance of nutrition in intensive care unit grows, large prospective randomized controlled trials on nutrition therapy have been performed and recently published. Each society for Parenteral and Enteral Nutrition designated recommendations for clinical practice based on the best available evidence and the consensus of experts. The European Society for Parenteral and Enteral Nutrition (ESPEN) has released a new guideline that has been updated from the previous ESPEN guidelines on enteral nutrition and parenteral nutrition in adult critically ill patients published in 2006 and 2009, respectively. This study examined the latest trends of nutrition guidelines, and especially those of the ESPEN 2018, for intensive care units as compared to guidelines of other societies and older previous guidelines.

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Changes in 2015 Canadian Clinical Practice Guidelines
Dae-Sang Lee
J Clin Nutr 2015;7(3):70-74.   Published online December 31, 2015
DOI: https://doi.org/10.15747/jcn.2015.7.3.70
AbstractAbstract PDF

Careful nutritional strategy is an essential component in the management of critically ill patients. Evidence-based clinical practice guidelines can be an effective solution to improving the process and structure of nutritional strategy for critically ill patients. The 2015 Canadian clinical practice guidelines (CPGs) summarized the evidence from approximately 354 randomized controlled trials in the area of critical care nutrition since 1980. The Canadian CPGs were first developed in 2003 and have been updated every 2 years. It is important for the acquisition of new evidence-based knowledge. This paper includes a brief summary on changes in 2015 CPGs compared with 2013 CPGs.

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