Anwar Elias Owais1, Syed Irfan Kabir1, Clare Mcnaught1, Marcel Gatt2, John MacFie3. 1. The Combined Gastroenterology Research Unit, Scarborough General Hospital, Woodlands Drive, Scarborough YO12 6QL, United Kingdom. 2. The Combined Gastroenterology Research Unit, Scarborough General Hospital, Woodlands Drive, Scarborough YO12 6QL, United Kingdom. Electronic address: marcelgatt@gmail.com. 3. The Combined Gastroenterology Research Unit, Scarborough General Hospital, Woodlands Drive, Scarborough YO12 6QL, United Kingdom; Postgraduate Medical Institute, The University of Hull, Hull HU6 7RX, United Kingdom.
Abstract
BACKGROUND & AIMS: The importance of adequate nutritional support is well established, but characterising what 'adequate nutrition' represents remains contentious. In recent years there has been increasing interest in the concept of 'permissive underfeeding' where patients are intentionally prescribed less nutrition than their calculated requirements. The aim of this study was to evaluate the effect of permissive underfeeding on septic and nutrition related morbidity in patients requiring short term parenteral nutrition (PN). METHODS: This was a single-blinded randomised clinical trial of 50 consecutive patients requiring parenteral nutritional support. Patients were randomized to receive either normocaloric or hypocaloric feeding (respectively 100% vs. 60% of estimated requirements). The primary end point was septic complications. Secondary end points included the metabolic, physiological and clinical outcomes to the two feeding protocols. RESULTS: Permissive underfeeding was associated with fewer septic complications (3 vs. 12 patients; p = 0.003), and a lower incidence of the systemic inflammatory response syndrome (9 vs. 16 patients; p = 0.017). Permissively underfed patients had fewer feed related complications (2 vs. 9 patients; p = 0.016). CONCLUSION: Permissive underfeeding in patients requiring short term PN appears to be safe and may results in reduced septic and feed-related complications. TRIAL REGISTRATION: NCT01154179 TRIAL REGISTRY: http://clinicaltrials.gov/ct2/show/NCT01154179.
RCT Entities:
BACKGROUND & AIMS: The importance of adequate nutritional support is well established, but characterising what 'adequate nutrition' represents remains contentious. In recent years there has been increasing interest in the concept of 'permissive underfeeding' where patients are intentionally prescribed less nutrition than their calculated requirements. The aim of this study was to evaluate the effect of permissive underfeeding on septic and nutrition related morbidity in patients requiring short term parenteral nutrition (PN). METHODS: This was a single-blinded randomised clinical trial of 50 consecutive patients requiring parenteral nutritional support. Patients were randomized to receive either normocaloric or hypocaloric feeding (respectively 100% vs. 60% of estimated requirements). The primary end point was septic complications. Secondary end points included the metabolic, physiological and clinical outcomes to the two feeding protocols. RESULTS: Permissive underfeeding was associated with fewer septic complications (3 vs. 12 patients; p = 0.003), and a lower incidence of the systemic inflammatory response syndrome (9 vs. 16 patients; p = 0.017). Permissively underfed patients had fewer feed related complications (2 vs. 9 patients; p = 0.016). CONCLUSION: Permissive underfeeding in patients requiring short term PN appears to be safe and may results in reduced septic and feed-related complications. TRIAL REGISTRATION: NCT01154179 TRIAL REGISTRY: http://clinicaltrials.gov/ct2/show/NCT01154179.
Authors: Cesar Augusto Flores Dueñas; Soila Maribel Gaxiola Camacho; Martin Francisco Montaño Gómez; Rafael Villa Angulo; Idalia Enríquez Verdugo; Tomás Rentería Evangelista; José Ascención Pérez Corrales; Miguel Ángel Rodríguez Gaxiola Journal: Ir Vet J Date: 2021-06-03 Impact factor: 2.146
Authors: Mario I Perman; Agustín Ciapponi; Juan Va Franco; Cecilia Loudet; Adriana Crivelli; Virginia Garrote; Gastón Perman Journal: Cochrane Database Syst Rev Date: 2018-06-04