Impact of medical nutrition
therapy in critical care
EuroPN study results

Can medical nutrition therapy improve patient outcomes?

Early medical nutrition therapy with moderate calorie and protein intake* is associated with improved clinical outcomes in critically ill patients. This practice is in line with current ESPEN ICU guidelines.¹

* 10-20 kcal/kg per day, 0.8 - 1.2 g protein/kg per day

Adressing unmet needs:Why was the EuroPN study initiated?

#1 Need for
improvement

The majority of critically ill patients do not receive adequate nutritional intake according to guideline targets.^2,3 Currently, there is no study assessing the level of adherence to the new ESPEN ICU recommendations.

#2 Need for
real-world data

The United for Clinical Nutrition EuroPN study addresses an urgent need to understand current nutrition practice and its association with clinical outcomes, ensuring optimal nutrition in critical care.

Filling the gap: What makes the EuroPN survey unique?

One of the largest prospective studies providing real-world evidence about nutrition and its associations with clinical outcomes in critically ill adult patients treated in European ICUs for a minimum ICU length of stay of 5 days

77 ICUs in 11 European countries participated in the study and 1,172 patients were enrolled

Documentation of nutrition parameters for 15 days in the ICU

Clinical outcomes were evaluated up to day 90 after the ICU stay such as duration of invasive mechanical ventilation and overall survival

Characterization of study population:
- 50% non-surgical patients
- 50% surgical patients
- Median APACHE II score 19.0
- Median SOFA score 7.0

Key findings: What are the most important take-aways?

Early and progressive medical nutrition therapy was provided

EN and/or PN was started on median day 2 after ICU admission and was progressively increased as suggested by the ESPEN ICU guidelines.
More than half of the patients were in need of nutritional support, either EN and/or PN, on day 3 after ICU admission.

Early moderate daily calorie and protein intakes were associated with improved clinical outcomes

Daily caloric intake of 10-20 kcal/kg was associated with better survival over 90 days compared to lower (< 10 kcal/kg/day) intake.

Early moderate daily calorie and protein intakes were associated with improved clinical outcomes

Daily caloric intake of 10–20 kcal/kg and protein intake of 0.8-1.2 g/kg was associated with earlier weaning from invasive mechanical ventilation compared to lower (<10kcal/kg and <0.8 g/kg) or higher (>20kcal/kg and >1.2 g/kg) daily intakes.

Early and moderate nutrition improves clinical outcomes!

Confirming current ESPEN ICU guidelines, the EuroPN Survey has shown that early medical nutrition therapy with moderate daily calorie and protein intake improves clinical outcomes such as an increased overall survival and earlier weaning from mechanical ventilation in critically ill patients.

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Publication - open access

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References:

1. Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clinical Nutrition. 2019;38(1):48–79.

2. Heyland DK, Dhaliwal R, Wang M, Day AG. The prevalence of iatrogenic underfeeding in the nutritionally ‘at-risk’critically ill patient: Results of an international, multicenter, prospective study. Clinical Nutrition. 2015;34(4):659-666.

3. Vallejo KP, Martínez CM, Adames AAM, et al. Current clinical nutrition practices in critically ill patients in Latin America: a multinational observational study. Critical Care. 2017;21(1):1-11.

Impact of medical nutrition therapy in critical care EuroPN study results