Initial nutritional management during noninvasive ventilation and outcomes: a retrospective cohort study View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-11-29

AUTHORS

Nicolas Terzi, Michael Darmon, Jean Reignier, Stéphane Ruckly, Maïté Garrouste-Orgeas, Alexandre Lautrette, Elie Azoulay, Bruno Mourvillier, Laurent Argaud, Laurent Papazian, Marc Gainnier, Dan Goldgran-Toledano, Samir Jamali, Anne-Sylvie Dumenil, Carole Schwebel, Jean-François Timsit, Jean-François Timsit, Elie Azoulay, Maïté Garrouste-Orgeas, Jean-Ralph Zahar, Christophe Adrie, Michael Darmon, Christophe Clec’h, Jean-Francois Timsit, Corinne Alberti, Stephane Ruckly, Sébastien Bailly, Lenka Styfalova, Aurélien Vannieuwenhuyze, Christophe Adrie, Bernard Allaouchiche, Laurent Argaud, Claire Ara-Somohano, Elie Azoulay, Francois Barbier, Julien Bohé, Christine Cheval, Christophe Clec’h, Michael Darmon, Anne-Sylvie Dumenil, Claire Dupuis, Jean-Marie Forel, Marc Gainier, Akim Haouache, Samir Jamali, Hatem Khallel, Alexandre Lautrette, Guillaume Marcotte, Eric Le Miere, Maxime Lugosi, Bruno Mourvillier, Benoît Misset, Delphine Moreau, Bruno Mourvillier, Laurent Papazian, Benjamin Planquette, Bertrand Souweine, Carole Schwebel, Nicolas Terzi, Gilles Troché, Marie Thuong, Guillaume Thierry, Dany Toledano, Eric Vantalon, Julien Fournier, Caroline Tournegros, Stéphanie Bagur, Mireille Adda, Vanessa Vindrieux, Loic Ferrand, Nadira Kaddour, Boris Berthe, Samir Bekkhouche, Kaouttar Mellouk, Sylvie Conrozier, Igor Theodose, Veronique Deiler, Sophie Letrou

ABSTRACT

BACKGROUND: Patients starting noninvasive ventilation (NIV) to treat acute respiratory failure are often unable to eat and therefore remain in the fasting state or receive nutritional support. Maintaining a good nutritional status has been reported to improve patient outcomes. In the present study, our primary objective was to describe the nutritional management of patients starting first-line NIV, and our secondary objectives were to assess potential associations between nutritional management and outcomes. METHODS: Observational retrospective cohort study of a prospective database fed by 20 French intensive care units. Adult medical patients receiving NIV for more than 2 consecutive days were included and divided into four groups on the basis of nutritional support received during the first 2 days of NIV: no nutrition, enteral nutrition, parenteral nutrition only, and oral nutrition only. RESULTS: Of the 16,594 patients admitted during the study period, 1075 met the inclusion criteria; of these, 622 (57.9%) received no nutrition, 28 (2.6%) received enteral nutrition, 74 (6.9%) received parenteral nutrition only, and 351 (32.7%) received oral nutrition only. After adjustment for confounders, enteral nutrition (vs. no nutrition) was associated with higher 28-day mortality (adjusted HR, 2.3; 95% CI, 1.2-4.4) and invasive mechanical ventilation needs (adjusted HR, 2.1; 95% CI, 1.1-4.2), as well as with fewer ventilator-free days by day 28 (adjusted relative risk, 0.7; 95% CI, 0.5-0.9). CONCLUSIONS: Nearly three-fifths of patients receiving NIV fasted for the first 2 days. Lack of feeding or underfeeding was not associated with mortality. The optimal route of nutrition for these patients needs to be investigated. More... »

PAGES

293

Journal

TITLE

Critical Care

ISSUE

1

VOLUME

21

Author Affiliations

  • Service de Réanimation Médicale, Centre Hospitalier Universitaire Grenoble – Alpes, CS10217 Grenoble, cedex 09 France
  • Medical Intensive Care Unit, Saint-Etienne University Hospital, Saint-Priest en Jarez, France
  • Medical Intensive Care Unit, Nantes University Hospital Center, Nantes, France
  • UMR 1137, Infection Antimicrobials Modelling Evolution (IAME) Team 5, Decision Sciences in Infectious Diseases (DeSCID), Control and Care, Sorbonne Paris Cité, Inserm/Paris Diderot University, Paris, France
  • Polyvalent Intensive Care Unit, Groupe Hospitalier Saint-Joseph, Paris, France
  • Medical Intensive Care Unit, Gabriel Montpied University Hospital, Clermont-Ferrand, France
  • Service de Réanimation Médicale, CHU Saint-Louis, Assistance Publique – Hôpitaux de Paris, Paris, France
  • Réanimation Médicale et Infectieuse, Hôpital Bichat Claude Bernard, Assistance Publique – Hôpitaux de Paris, Paris, France
  • Medical Intensive Care Unit, Lyon University Hospital, Lyon, France
  • Réanimation des Détresses Respiratoires et Infections Sévères, Hôpital Nord, Aix-Marseille University, Assistance Publique – Hôpitaux de Marseille, Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), UMR CNRS 7278, Marseille, France
  • Réanimation des Urgences et Medicale, CHU la Timone 2 Marseille, Aix-Marseille Université, 13385 Marseille, France
  • Medical-Surgical Intensive Care Unit, Gonesse Hospital, Gonesse, France
  • Medical-Surgical Intensive Care Medicine Unit, Dourdan Hospital, Dourdan, France
  • Medical-Surgical Intensive Care Unit, Assistance Publique – Hôpitaux de Paris, Antoine Béclère University Hospital, Clamart, France
  • Integrated Research Center, Inserm U1039, Radiopharmaceutical Bioclinical Mixed Research Unit, University Joseph Fourier, Grenoble, France
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/s13054-017-1867-y

    DOI

    http://dx.doi.org/10.1186/s13054-017-1867-y

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1093055170

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/29187261


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