000151412 001__ 151412
000151412 005__ 20251017144640.0
000151412 0247_ $$2doi$$a10.3389/fnut.2023.1250305
000151412 0248_ $$2sideral$$a143122
000151412 037__ $$aART-2023-143122
000151412 041__ $$aeng
000151412 100__ $$aLopez-Delgado, Juan Carlos
000151412 245__ $$aFactors associated with the need of parenteral nutrition in critically ill patients after the initiation of enteral nutrition therapy
000151412 260__ $$c2023
000151412 5060_ $$aAccess copy available to the general public$$fUnrestricted
000151412 5203_ $$aBackground and aimsDespite enteral nutrition (EN) is the preferred route of nutrition in patients with critical illness, EN is not always able to provide optimal nutrient provision and parenteral nutrition (PN) is needed. This is strongly associated with gastrointestinal (GI) complications, a feature of gastrointestinal dysfunction and disease severity. The aim of the present study was to investigate factors associated with the need of PN after start of EN, together with the use and complications associated with EN.MethodsAdult patients admitted to 38 Spanish intensive care units (ICUs) between April and July 2018, who needed EN therapy were included in a prospective observational study. The characteristics of EN-treated patients and those who required PN after start EN were analyzed (i.e., clinical, laboratory and scores).ResultsOf a total of 443 patients, 43 (9.7%) received PN. One-third (29.3%) of patients presented GI complications, which were more frequent among those needing PN (26% vs. 60%, p = 0.001). No differences regarding mean energy and protein delivery were found between patients treated only with EN (n = 400) and those needing supplementary or total PN (n = 43). Abnormalities in lipid profile, blood proteins, and inflammatory markers, such as C-Reactive Protein, were shown in those patients needing PN. Sequential Organ Failure Assessment (SOFA) on ICU admission (Hazard ratio [HR]:1.161, 95% confidence interval [CI]:1.053–1.281, p = 0.003) and modified Nutrition Risk in Critically Ill (mNUTRIC) score (HR:1.311, 95% CI:1.098–1.565, p = 0.003) were higher among those who needed PN. In the multivariate analysis, higher SOFA score (HR:1.221, 95% CI:1.057–1.410, p = 0.007) and higher triglyceride levels on ICU admission (HR:1.004, 95% CI:1.001–1.007, p = 0.003) were associated with an increased risk for the need of PN, whereas higher albumin levels on ICU admission (HR:0.424, 95% CI:0.210–0.687, p = 0.016) was associated with lower need of PN.ConclusionA higher SOFA and nutrition-related laboratory parameters on ICU admission may be associated with the need of PN after starting EN therapy. This may be related with a higher occurrence of GI complications, a feature of GI dysfunction.Clinical trial registrationClinicalTrials.gov: NCT03634943.
000151412 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es
000151412 590__ $$a4.0$$b2023
000151412 591__ $$aNUTRITION & DIETETICS$$b31 / 114 = 0.272$$c2023$$dQ2$$eT1
000151412 592__ $$a0.828$$b2023
000151412 593__ $$aFood Science$$c2023$$dQ1
000151412 593__ $$aNutrition and Dietetics$$c2023$$dQ2
000151412 593__ $$aEndocrinology, Diabetes and Metabolism$$c2023$$dQ2
000151412 594__ $$a5.2$$b2023
000151412 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000151412 700__ $$aServia-Goixart, Lluís
000151412 700__ $$aGrau-Carmona, Teodoro
000151412 700__ $$aBordeje-Laguna, Luisa
000151412 700__ $$aPortugal-Rodriguez, Esther
000151412 700__ $$aLorencio-Cardenas, Carolina
000151412 700__ $$aVera-Artazcoz, Paula
000151412 700__ $$aMacaya-Redin, Laura
000151412 700__ $$aMartinez-Carmona, Juan Francisco
000151412 700__ $$aMarin Corral, Judith
000151412 700__ $$aFlordelís-Lasierra, Jose Luis
000151412 700__ $$0(orcid)0000-0002-8068-5016$$aSeron-Arbeloa, Carlos$$uUniversidad de Zaragoza
000151412 700__ $$aAlcazar-Espin, Maravillas de las Nieves
000151412 700__ $$aNavas-Moya, Elisabeth
000151412 700__ $$aAldunate-Calvo, Sara
000151412 700__ $$aNieto Martino, Beatriz
000151412 700__ $$aMartinez de Lagran, Itziar
000151412 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000151412 773__ $$g10 (2023), 1250305 [12 pp.]$$pFront. Nutr.$$tFrontiers in Nutrition$$x2296-861X
000151412 8564_ $$s1991504$$uhttps://zaguan.unizar.es/record/151412/files/texto_completo.pdf$$yVersión publicada
000151412 8564_ $$s2468074$$uhttps://zaguan.unizar.es/record/151412/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
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000151412 951__ $$a2025-10-17-14:31:34
000151412 980__ $$aARTICLE