Delving into NUTRIREA 3 vs NUTRIREA 1, the hosts discuss calorie feeding in ventilated adults with shock and the importance of monitoring gastric volumes. They explore patient cohorts, nutritional interventions, and personalized nutrition strategies in critical care, highlighting debates on weaning criteria and traditional practices.
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Quick takeaways
The Nutra Rhea 3 study showed no significant difference in 90-day mortality but a faster ICU discharge readiness in the lower calorie group.
Recent trials question the benefits of full feeding in critically ill patients, suggesting similar outcomes with lower feeding strategies.
Deep dives
Nutra Rhea 3 Study Overview
The Nutra Rhea 3 study compared low versus standard calorie and protein feeding in ventilated adults with shock. Conducted in 61 ICUs in France with 3,044 patients, the study found no significant difference in 90-day mortality but a faster time to readiness for ICU discharge in the lower calorie group. While some debates exist on the impact of full feeding, the study suggests similar outcomes with lower feeding strategies in critically ill patients.
Nutrition in ICU Evolution
The podcast delves into the evolution of critical care nutrition, highlighting how past studies linked malnutrition in critically ill patients with poor outcomes. Recent trials, including Eden and others, compared higher versus lower calorie and protein administration, indicating that fully feeding patients from ICU admission may not yield better outcomes. This shift prompts a reconsideration of default full feeding approaches in early critical illness stages.
Nutra Rhea 3 Outcomes Analysis
In the Nutra Rhea 3 study, key outcomes included comparable 90-day mortality rates but a significant difference in time to readiness for ICU discharge, favoring the lower calorie group. The discussion surrounds the interpretation of this outcome, questioning the impact of rapid weaning from mechanical ventilation on discharge readiness and emphasizing the need for personalized nutrition strategies based on disease phases and patient subpopulations.
Gastric Residual Volumes and ICU Nutrition
Exploring the Nutra Rhea 1 study, which focused on the effects of not monitoring residual gastric volumes, revealed no significant difference in ventilator-associated pneumonia rates between groups. Debates arise regarding the utility of routinely checking gastric residual volumes in ICU patients, with insights suggesting potential flaws in this practice and considerations for tailored nutritional approaches based on patient conditions.
Episode 8! In this episode we discuss NUTRIREA 3 or "Low versus standard calorie and protein feeding in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group trial" by Reigner et al published Lancet Respiratory Medicine 2023.
The "old" article is NUTRIREA 1 or "Effect of not monitoring residual gastric volume on risk of ventilator-associated pneumonia in adults receiving mechanical ventilation and early enteral feeding: a randomized controlled trial"
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