First international meeting of early career investigators: Current opportunities, challenges and horizon in critical care nutrition research

Christian Stoppe,Sebastian Pablo Chapela,Mette M Berger,Albert Albay,Robert Martindale,Filippo Giorgio Di Girolamo,Robert Van Gassel,Tim Friede,Joop Jonckheer,Sanit Wichansawakun,Maria Eloisa Garcia Velasquez

doi:10.1016/j.clnesp.2020.09.006

Abstract

Appropriate nutritional support is a key component of care for critically ill patients. While malnutrition increases complications, impacting long term outcomes and healthcare-related costs, uncertainties persist regarding optimal provision of nutritional support in this setting. An international group of healthcare providers (HCPs) from critical care specialties and nutrition researchers convened to identify knowledge gaps and learnings from studies in critical care nutrition. Clinical research needs were identified in order to better inform future nutrition practices. Challenges in critical care nutrition arise, in part, from inconsistent outcomes in several large-scale studies regarding the optimal amount of calories and protein to prescribe, the optimal time to initiate nutritional support and the role of parental nutrition to support critically ill patients. Furthermore, there is uncertainty on how best to identify patients at nutritional risk, and the appropriate outcome measures for ICU nutrition studies. Given HCPs have a suboptimal evidence base to inform the nutritional management of critically ill patients, further well-designed clinical trials capturing clinically relevant endpoints are needed to address these knowledge gaps. The identified aspects for future research could be addressed in studies designed and conducted in collaboration with an international team of interdisciplinary nutrition experts. The aim of this collaboration is to address the unmet need for robust clinical data needed to develop high-quality evidence-based nutritional intervention recommendations to better inform the future management of critically ill patients.

Highlights

Despite nutrition support being captured in basic care bundles as a crucial component of critical care, many critically ill patients fail to receive adequate nutritional intake [1]
Protein and energy deficiencies are reported in 43e88% of critically ill patients [2,3], and malnutrition is associated with increased rates of complications, prolonged stay in the intensive care unit (ICU) and negatively impacts mortality [4e8]
The aim of this paper is to summarize the outcomes of these discussions, focussing on how the identified knowledge gaps can best addressed in future studies, and the challenges and opportunities facing researchers in critical care nutrition

Summary

Introduction

Despite nutrition support being captured in basic care bundles as a crucial component of critical care, many critically ill patients fail to receive adequate nutritional intake [1]. Limited high quality data underscores the need for new, well designed multicentre studies that accurately capture the medical needs and perspectives of critically ill patients in order to address the nutritional knowledge gaps and optimize care. The aim of this paper is to summarize the outcomes of these discussions, focussing on how the identified knowledge gaps can best addressed in future studies, and the challenges and opportunities facing researchers in critical care nutrition. Given HCPs have a suboptimal evidence base to inform the nutritional management of critically ill patients, further well-designed clinical trials capturing clinically relevant endpoints are needed to address these knowledge gaps. Conclusions: The identified aspects for future research could be addressed in studies designed and conducted in collaboration with an international team of interdisciplinary nutrition experts The aim of this collaboration is to address the unmet need for robust clinical data needed to develop high-quality

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