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  • CALORIES trial offers confirmatory evidence that parenteral nutrition does not cause infectious complications in critically ill patients

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Therapeutics/Prevention
Randomised controlled trial
CALORIES trial offers confirmatory evidence that parenteral nutrition does not cause infectious complications in critically ill patients
  1. Gordon S Doig,
  2. Fiona Simpson
  1. Intensive Care Research Unit, Northern Clinical School, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to : Gordon S Doig, Intensive Care Research Unit, Northern Clinical School, Royal North Shore Hospital, University of Sydney, Pacific Hwy, St. Leonards, Sydney, NSW 2065, Australia; gdoig{at}med.usyd.edu.au

https://doi.org/10.1136/ebmed-2014-110132

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    Commentary on: Harvey SE, Parrott F, Harrison DA, et al.; CALORIES Trial Investigators. Trial of the route of early nutritional support in critically ill adults. N Engl J Med 2014;371:1673–84.OpenUrlCrossRefPubMedWeb of Science

    Context

    Critically ill patients are hypermetabolic and have increased nutritional requirements. Major international guidelines promote early enteral nutrition (EN), however, up to 35% of all patients remain unfed 3 or more days after intensive care unit (ICU) admission.1 EN is delayed because clinicians believe it is poorly absorbed in critical illness and because they believe excess vomiting may lead to pneumonitis. Parenteral nutrition (PN), an intravenous solution containing glucose, amino acids and lipids, is intuitively appealing because it avoids perceived complications related to gastric dysfunction while providing necessary calories and protein.

    A meta-analysis of clinical trials comparing PN with EN …

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    Footnotes

    • Competing interests None.

    • Provenance and peer review Commissioned; internally peer reviewed.