AI Article Synopsis
- A study called the NUTRIREA-3 trial explored whether lower calorie and protein intake during the early treatment of critically ill patients could lead to better outcomes compared to standard nutrition guidelines.
- Conducted in 61 ICUs across France, the trial involved over 3,000 patients who received either low or standard nutrition after being put on mechanical ventilation for shock.
- Results showed no significant difference in 90-day mortality rates but indicated that patients on the low nutrition plan had a slightly quicker ICU discharge time and experienced fewer gastrointestinal issues and liver dysfunction.
Article Abstract
Background: The optimal calorie and protein intakes at the acute phase of severe critical illness remain unknown. We hypothesised that early calorie and protein restriction improved outcomes in these patients, compared with standard calorie and protein targets.
Methods: The pragmatic, randomised, controlled, multicentre, open-label, parallel-group NUTRIREA-3 trial was performed in 61 French intensive care units (ICUs). Adults (≥18 years) receiving invasive mechanical ventilation and vasopressor support for shock were randomly assigned to early nutrition (started within 24 h after intubation) with either low or standard calorie and protein targets (6 kcal/kg per day and 0·2-0·4 g/kg per day protein vs 25 kcal/kg per day and 1·0-1·3 g/kg per day protein) during the first 7 ICU days. The two primary endpoints were time to readiness for ICU discharge and day 90 all-cause mortality. Key secondary outcomes included secondary infections, gastrointestinal events, and liver dysfunction. The trial is registered on ClinicalTrials.gov, NCT03573739, and is completed.
Findings: Of 3044 patients randomly assigned between July 5, 2018, and 8 Dec 8, 2020, eight withdrew consent to participation. By day 90, 628 (41·3%) of 1521 patients in the low group and 648 (42·8%) of 1515 patients in the standard group had died (absolute difference -1·5%, 95% CI -5·0 to 2·0; p=0·41). Median time to readiness for ICU discharge was 8·0 days (IQR 5·0-14·0) in the low group and 9·0 days (5·0-17·0) in the standard group (hazard ratio [HR] 1·12, 95% CI 1·02 to 1·22; p=0·015). Proportions of patients with secondary infections did not differ between the groups (HR 0·85, 0·71 to 1·01; p=0·06). The low group had lower proportions of patients with vomiting (HR 0·77, 0·67 to 0·89; p<0·001), diarrhoea (0·83, 0·73 to 0·94; p=0·004), bowel ischaemia (0·50, 0·26 to 0·95; p=0·030), and liver dysfunction (0·92, 0·86-0·99; p=0·032).
Interpretation: Compared with standard calorie and protein targets, early calorie and protein restriction did not decrease mortality but was associated with faster recovery and fewer complications.
Funding: French Ministry of Health.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/S2213-2600(23)00092-9 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
De novo biosynthesis of mogroside V by multiplexed engineered yeasts.
Metab Eng
January 2025
Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, Jiangnan University, Wuxi, 214122, China; Science Center for Future Foods, Jiangnan University, Wuxi 214122, China; Jiangsu Province Basic Research Center for Synthetic Biology, Jiangnan University, Wuxi 214122, China. Electronic address:
High sugar intake has become a global health concern due to its association with various diseases. Mogroside V (MG-V), a zero-calorie sweetener with multiple medical properties, is emerging as a promising sugar substitute. However, its application is hindered by low natural abundance and the inefficiency of conventional plant extraction methods.
View Article and Find Full Text PDFQuantity of Caloric Support After Pediatric Severe Traumatic Brain Injury: Description of Associated Outcomes in a Single Retrospective Center Cohort, 2010-2022.
Pediatr Crit Care Med
January 2025
Department of Pediatrics, Division of Critical Care Medicine, Children's National Hospital and The George Washington University School of Medicine and Health Sciences, Washington, DC.
Objectives: To examine the relationship between adequacy of caloric nutritional support during the first week after severe traumatic brain injury (TBI) and outcome.
Design: Single-center retrospective cohort, 2010-2022.
Setting: Tertiary care children's hospital with a level 1 trauma center.
Sexual dimorphism in lung transcriptomic adaptations in fetal alcohol spectrum disorders.
Respir Res
January 2025
Department of Obstetrics and Gynecology, C.S. Mott Center for Human Growth and Development, School of Medicine, Wayne State University, 275 E Hancock St, Rm 195, Detroit, MI, 48201, USA.
Current fetal alcohol spectrum disorders (FASD) studies primarily focus on alcohol's actions on the fetal brain although respiratory infections are a leading cause of morbidity/mortality in newborns. The limited studies examining the pulmonary adaptations in FASD demonstrate decreased surfactant protein A and alveolar macrophage phagocytosis, impaired differentiation, and increased risk of Group B streptococcal pneumonia with no study examining sexual dimorphism in adaptations. We hypothesized that developmental alcohol exposure in pregnancy will lead to sexually dimorphic fetal lung morphological and immune adaptations.
View Article and Find Full Text PDFTowards healthier low-sugar and low-fat beverages: Design, production, and characterization.
Food Res Int
January 2025
State Key Laboratory of Tea Plant Biology and Utilization, School of Tea and Food Science & Technology, Anhui Agricultural University, Hefei, 230036, China; Joint Research Center for Food Nutrition and Health of IHM, Anhui Agricultural University, Hefei 230036, Anhui, China; Anhui Provincial Key Laboratory of Food Safety Monitoring and Quality Control, New-style Industrial Tea Beverage Green Manufacturing Joint Laboratory of Anhui Province, Anhui Agricultural University, Hefei, China. Electronic address:
Many consumers are adopting low-sugar and low-fat beverages to avoid excessive calories and the negative impact of high trans- and/or saturated fat on health and wellbeing. This article reviews strategies to reduce sugar, fat, and high trans- and/or saturated fat content in beverages while maintaining their desirable physicochemical and sensory attributes. It assesses the impact of various sugar and fat replacers on the aroma, taste, texture, appearance, and nutritional profile of beverages.
View Article and Find Full Text PDFImpact of cold plasma-assisted Non-thermal deamidation and glycosylation on the construction of sugar derivative-zein conjugates for enhancing pickering foam stability: Technical principles and molecular interactions.
Food Res Int
January 2025
State Key Laboratory of Food Nutrition and Safety, Key Laboratory of Food Nutrition and Safety, Ministry of Education, College of Food Science and Engineering, Tianjin University of Science & Technology, No. 9, No. 13 Ave., TEDA, Tianjin 300457, China. Electronic address:
There is an urgent need for stable, plant-based Pickering foams to address the growing consumer demand for sustainable, low-calorie, aerated sweet foods. This study employed a cold plasma-assisted deamidation and glycosylation (CPDG) approach to promote hydrophilic reassembly of zein, resulting in the formation of sugar derivative-zein conjugates. This was accomplished by coupling deamidated zein with polyhydroxy sugars including sucralose (Suc), maltitol (Mal), mannitol (Man), and stevioside (Ste).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!