Critical Care
To help improve outcomes, patients in the ICU require early and appropriate nutrition based on their condition/diagnosis. Abbott Nutrition can assist you in providing the appropriate formula to meet your patients’ specific nutritional needs. An algorithm published in 2011 can provide guidance on how, when, and what to feed your patients based on clinical conditions.1 Other Critical Care Guidelines 2,3 may also be helpful in guiding you in selecting the appropriate product that will meet your patients' individual needs.
Clinical Studies in the ICU
Studies in critically ill patients provide valuable insight on critical care nutrition practice and feeding strategies; the Nutrition Studies in the ICU Overview provides a high level overview of some of these key studies. An overview is also available of studies that fed specific nutrients and products in the critically ill patient population. These studies highlight outcomes using Oxepa, Pivot, and Vital.
Nutrition Studies in the ICU
A helpful summary of clinical studies related to the critically ill being treated in the ICU.
Abbott Nutrition Product Studies in the ICU
A helpful summary of clinical studies concerning the effectiveness of Abbott Nutrition’s products being used within the ICU.
Clinical Study – Vital
Feeding a peptide-based enteral formula to critically ill patients can promote feeding tolerance compared to a polymeric enteral formula. A poster and abstract presented at Clinical Nutrition Week (CNW) in 2015 showed that patients in the ICU who were fed Vital AF 1.2 Cal experienced fewer days of GI complications and fewer days of distension compared to patients who were fed Osmolite.
Clinical Summary - Oxepa
Oxepa has been studied in patients on mechanical ventilation with SIRS, ALI, and ARDS. The INTERSEPT Study published in 2011 provides evidence that use of an enteral formula with EPA, GLA, and elevated antioxidants (Oxepa) in patients with early stages of sepsis without any organ failure can slow the progression of the disease to severe sepsis and/or septic shock.4
Clinical Summary - Pivot
An abstract and poster presented at CNW in 2011 highlighted fewer infectious complications and decreased hospital length of stay in post-operative cardiac surgery patients when using Pivot 1.5 Cal vs. standard enteral formulations with no fish oil or added arginine.5
Volume-based feeding has been shown to increase the amount of calories and protein delivered to critically ill patients compared to rate-based feeding. Please download the Heyland study overview for more information on volume-based feeding methods as well as an example of an order set from Cox Health. Contact your Abbott Nutrition Representative for more detailed information.
Heyland PepUp Clinical Summary
Cox Health ICU Feeding Order Set
Immunutrition, both oral and enteral, has been studied in surgical patients who are at risk of infection and other complications in the hospital. Pre- and postoperative nutrition has been shown to play a role in minimizing the stresses of surgery and hospitalization. A meta-analysis published in 2014 showed that standard oral nutritional supplements can be an appropriate source of pre-operative nutrition, while postoperative feeding of immunonutritional supplements can improve clinical outcomes. The study overview can be viewed by clicking the link below.
Hegazi & Evans Meta-Analysis Summary
References
- Hegazi RA, Wischmeyer PE. Crit Care. 2011;15:234
- McClave SA, Martindale RG, Vanek VW, et al. JPEN J Parenter Enteral Nutr. May-Jun 2009;33(3):277-316.
- Critical Care Nutrition. 2015 Canadian Clinical Practice Guidelines http://www.criticalcarenutrition.com/index.php?option=com_content&view=category&layout=blog&id=25&Itemid=109. Accessed June 18, 2015.
- Pontes-Arruda A, Martins LF, de Lima SM, et al. Crit Care. 2011;15(3):R144.
- Bedi NM, McGurk S, Burgess AM, Rawn JD. JPEN J Parenter Enteral Nutr. 2011;35(1):138.