Full predicted energy from nutrition and the effect on mortality and infectious complications in critically ill adults

open access
 

Protocol

Full predicted energy from nutrition and the effect on mortality and infectious complications in critically ill adults: a protocol for a systematic review and meta-analysis of parallel randomised controlled trials

Background

Nutrition is vital to survival in health. In critical illness, however, the role of nutrition is less defined. More specifically, the exact amount of energy that is required during critical illness to optimally influence clinical outcomes remains unknown. Prolonged provision of nutrition below a patient’s individual nutrition requirements (including under provision of energy, specifically) can result in malnutrition. Whist the prevalence of malnutrition in critically ill patients is generally poorly documented, poorly defined, and varies depending on the criteria used, reports indicate that worldwide prevalence in hospitalised patients is between 20 and 50 % internationally [1]. Malnutrition is thus likely to be commonplace in critically ill patients. In the acute hospitalised population, malnutrition has been associated with many undesirable clinical consequences such as reduced immune function, increased length of hospital stay, impaired wound healing, muscle wasting and ultimately increased health care costs [1]. Conversely, it is known that excessive nutrition can lead to over provision of energy and result in adverse patient effects including increased metabolic stress, hyperglycaemia and deranged liver function [2].

Despite the known consequences of significant under- or overfeeding in critically ill patients, there is considerable uncertainty.....

Expected benefits of this review

This will be the first published systematic review and meta-analysis to our knowledge that will investigate the effect of delivering full predicted energy from nutrition on clinical outcomes in critically ill adults, compared to delivering less than full predicted energy requirements. The literature available on this topic is conflicting and confusing for clinicians and could potentially lead to misleading conclusions being made regarding the role of nutrition in critical illness. This systematic review and meta-analysis will benefit clinicians by providing a summary of the available literature and provide further guidance.