Metabolic support in the critically ill: a consensus of 19 - Université de Versailles Saint-Quentin-en-Yvelines Access content directly
Reports Year : 2019

Metabolic support in the critically ill: a consensus of 19

Jan Wernerman
  • Function : Author
Kenneth Christopher
  • Function : Author
Michael Casaer
  • Function : Author
Craig Coopersmith
  • Function : Author
Adam Deane
  • Function : Author
Elisabeth de Waele
  • Function : Author
Gunnar Elke
  • Function : Author
Carole Ichai
  • Function : Author
Constantine Karvellas
  • Function : Author
Stephen Mcclave
  • Function : Author
Heleen Oudemans-van Straaten
  • Function : Author
Olav Rooyackers
  • Function : Author
Renee Stapleton
  • Function : Author
Jukka Takala
  • Function : Author
Arthur van Zanten
  • Function : Author
Paul Wischmeyer
  • Function : Author
Jean-Charles Preiser
  • Function : Author
Jean-Louis Vincent

Abstract

Abstract Metabolic alterations in the critically ill have been studied for more than a century, but the heterogeneity of the critically ill patient population, the varying duration and severity of the acute phase of illness, and the many confounding factors have hindered progress in the field. These factors may explain why management of metabolic alterations and related conditions in critically ill patients has for many years been guided by recommendations based essentially on expert opinion. Over the last decade, a number of randomized controlled trials have been conducted, providing us with important population-level evidence that refutes several longstanding paradigms. However, between-patient variation means there is still substantial uncertainty when translating population-level evidence to individuals. A cornerstone of metabolic care is nutrition, for which there is a multifold of published guidelines that agree on many issues but disagree on others. Using a series of nine questions, we provide a review of the latest data in this field and a background to promote efforts to address the need for international consistency in recommendations related to the metabolic care of the critically ill patient. Our purpose is not to replace existing guidelines, but to comment on differences and add perspective.
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hal-04551392 , version 1 (18-04-2024)

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Jan Wernerman, Kenneth Christopher, Djillali Annane, Michael Casaer, Craig Coopersmith, et al.. Metabolic support in the critically ill: a consensus of 19. Université libre de Bruxelles (1970-..). Faculté de médecine. 2019, pp.318. ⟨hal-04551392⟩
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