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Start Over Author "Bordeje-Laguna ML" Topic enteral nutrition
2 results on '"Bordeje-Laguna ML"'

1. The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes?

Author

Lopez-Delgado JC, Grau-Carmona T, Trujillano-Cabello J, García-Fuentes C, Mor-Marco E, Bordeje-Laguna ML, Portugal-Rodriguez E, Lorencio-Cardenas C, Vera-Artazcoz P, Macaya-Redin L, Martinez-Carmona JF, Mateu-Campos L, Gero-Escapa M, Gastaldo-Simeon R, Vila-García B, Flordelis-Lasierra JL, Montejo-Gonzalez JC, Servia-Goixart L, and The Enpic Study Group

Subjects
Critical Illness therapy, Food, Formulated, Humans, Nutritional Support, Enteral Nutrition, Intensive Care Units
Abstract

Background: The present research aimed to evaluate the effect on outcomes of immunonutrition (IMN) enteral formulas during the intensive care unit (ICU) stay. Methods: A multicenter prospective observational study was performed. Patient characteristics, disease severity, nutritional status, type of nutritional therapy and outcomes, and laboratory parameters were collected in a database. Statistical differences were analyzed according to the administration of IMN or other types of enteral formulas. Results: In total, 406 patients were included in the analysis, of whom 15.02% (61) received IMN. Univariate analysis showed that patients treated with IMN formulas received higher mean caloric and protein intake, and better 28-day survival (85.2% vs. 73.3%; p = 0.014. Unadjusted Hazard Ratio (HR): 0.15; 95% CI (Confidence Interval): 0.06−0.36; p < 0.001). Once adjusted for confounding factors, multivariate analysis showed a lower need for vasopressor support (OR: 0.49; 95% CI: 0.26−0.91; p = 0.023) and continuous renal replacement therapies (OR: 0.13; 95% CI: 0.01−0.65; p = 0.049) in those patients who received IMN formulas, independently of the severity of the disease. IMN use was also associated with higher protein intake during the administration of nutritional therapy (OR: 6.23; 95% CI: 2.59−15.54; p < 0.001), regardless of the type of patient. No differences were found in the laboratory parameters, except for a trend toward lower triglyceride levels (HR: 0.97; 95% CI: 0.95−0.99; p = 0.045). Conclusion: The use of IMN formulas may be associated with better outcomes (i.e., lower need for vasopressors and continuous renal replacement), together with a trend toward higher protein enteral delivery during the ICU stay. These findings may ultimately be related to their modulating effect on the inflammatory response in the critically ill. NCT Registry: 03634943.

Published
2022
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2. Evaluation of Nutritional Practices in the Critical Care patient (The ENPIC study): Does nutrition really affect ICU mortality?

Author

Lluís Servia-Goixart, Juan C. Lopez-Delgado, Teodoro Grau-Carmona, Javier Trujillano-Cabello, M Luisa Bordeje-Laguna, Esther Mor-Marco, Esther Portugal-Rodriguez, Carol Lorencio-Cardenas, Juan C. Montejo-Gonzalez, Paula Vera-Artazcoz, Laura Macaya-Redin, Juan Francisco Martinez-Carmona, Rayden Iglesias-Rodriguez, Diana Monge-Donaire, José L. Flordelis-Lasierra, Beatriz Llorente-Ruiz, Eva M. Menor-Fernández, Itziar Martínez de Lagrán, Juan C. Yebenes-Reyes, Joan Escobar-Ortiz, Neus Montserrat-Ortiz, Amalia Zapata-Rojas, Iris Bautista-Redondo, Ana Cruz-Ramos, Laura Diaz-Castellanos, Miriam Morales-Cifuentes, Montserrat Plaza- Bono, Juan Carlos Montejo-Gonzalez, Susana Temprano-Vazquez, Veronica Arjona-Diaz, Carlos Garcia-Fuentes, Carolina Mudarra-Reche, Maria Orejana-Martin, Juan Carlos Lopez-Delgado, Africa Lores-Obradors, Laura Anguela-Calvet, Gloria Muñoz-Del Río, Pamela Alejandra Revelo-Esquibel, Henry Alanez-Saavedra, Pau Serra-Paya, Stephani Maria Luna-Solis, Alvaro Salinas-Canovas, Fernando De Frutos-Seminario, Oriol Rodriguez-Queralto, Carlos Gonzalez-Iglesias, Monica Zamora-Elson, Eugenia de la Fuente-O'Connor, Carlos Seron- Arbeloa, Nestor Bueno-Vidales, Ana Martin-Luengo, Angel Sanchez-Miralles, Enrique Marmol-Peis, Miriam Ruiz-Miralles, Maria Gonzalez-Sanz, Arantzazu Server-Martinez, Belen Vila-Garcia, Raquel Flecha-Viguera, Sara Aldunate-Calvo, Jose Luis Flordelis-Lasierra, Irene Jimenez-del Rio, Jose Ramon Mampaso-Recio, Jose Manuel Rodriguez-Roldan, Rosa Gastaldo-Simeon, Josefina Gimenez-Castellanos, Juan Francisco Fernandez-Ortega, Juan F. Martinez-Carmona, Esther Lopez-Luque, Ane Ortega-Ordiales, Monica Crespo-Gomez, Victor Ramirez-Montero, Esther Lopez-García, Arturo Navarro-Lacalle, Pilar Martinez-Garcia, Maria Inmaculada Dominguez-Fernandez, Marta Izura-Gomez, Susana Hernandez-Duran, Ma Luisa Bordeje-Laguna, Yaiza Rovira-Valles, Viridiana Philibert, Maravillas de las Nieves Alcazar-Espin, Aurea Higon-Cañigral, Enrique Calvo-Herranz, Diego Manzano-Moratinos, David Andaluz-Ojeda, Laura Parra-Morais, Rafael Citores-Gonzalez, Maria Teresa Garcia-Gonzalez, Gloria Renedo Sanchez-Giron, Elisabeth Navas-Moya, Carles Ferrer-Pereto, Cristina Lluch-Candal, Jessica Ruiz-Izquierdo, Silvia Castor-Bekari, Cristina Leon-Cinto, Itziar Martinez de Lagran, Juan Carlos Yebenes-Reyes, Beatriz Nieto-Martino, Clara Vaquerizo-Alonso, Susana Almanza-Lopez, Sonia Perez-Quesada, Jose Luis Anton-Pascual, Judith Marin-Corral, Maite Sistachs-Baquedano, Maria Hacer-Puig, Marina Picornell-Noguera, Lidon Mateu-Campos, Clara Martinez-Valero, Andrea Ortiz-Suñer, María Cristina Martinez-Diaz, Maria Trascasa- Muñoz De La Peña, Diego Anibal Rodriguez-Serrano, Leticia Fernandez-Salvatierra, Mireia Barcelo-Castello, Paula Millan-Taratiel, Antonio Tejada-Artigas, Ines Martinez-Arroyo, Pilar Araujo-Aguilar, Maria Fuster-Cabre, Laura Andres-Gines, Sonia Soldado-Olmo, Eva Mª Menor-Fernandez, Lucas Lage-Cendon, Alberto Touceda-Bravo, Laura Sanchez-Ales, Laura Almorin-Gonzalvez, Maria Gero-Escapa, Esther Martinez-Barrio, Sergio Ossa-Echeverri, [Servia-Goixart L, Trujillano-Cabello J] Hospital Universitari Arnau de Vilanova, Intensive Care Department, Lleida, Spain. IRBLLeida (Institut de Recerca Biomedica de Lleida Fundacio Dr. Pifarré, Lleida Biomedical Research Institute's Dr. Pifarré Foundation, Lleida, Spain. [Lopez-Delgado JC] Hospital Universitari de Bellvitge, Intensive Care Department, Hospitalet de Llobregat, Spain. IDIBELL (Institut d’Investigacio Biomédica Bellvitge, Biomedical Investigation Institute of Bellvitge, Hospitalet de Llobregat, Spain. [Grau-Carmona T] Hospital Universitario 12 de Octubre, Intensive Care Department, Madrid, Spain. i+12 (Instituto de Investigacion Sanitaria Hospital 12 de Octubre, Research Institute Hospital 12 de Octubre), Madrid, Spain. [Bordeje-Laguna ML, Mor-Marco E] Hospital Universitario Germans Trias i Pujol, Intensive Care Department, Badalona, Spain. [Iglesias-Rodriguez R] Hospital General de Granollers, Intensive Care Department, Granollers, Spain, and Hospital General de Granollers

Subjects
Adult, Parenteral Nutrition, Pediatrics, medicine.medical_specialty, Multivariate analysis, Critical Care, Endocrinology, Diabetes and Metabolism, Nutritional Status, Enteral administration, Nutritional therapy, Enteral Nutrition, Medicina intensiva, Epidemiology and Biostatistics::Biostatistics::Information Storage and Retrieval::Mortality Registries [PUBLIC HEALTH], Intensive care, Mortalitat, Medicine, Humans, Nutrició enteral, Critical care medicine, Intensive care unit, Medical nutrition therapy, Mortality, Nutrició, vigilancia sanitaria de los servicios de salud::centros sanitarios::hospitales::unidades hospitalarias::unidades de cuidados intensivos [VIGILANCIA SANITARIA], Nutrition, Therapeutics::Feeding Methods::Enteral Nutrition [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Nutrition and Dietetics, epidemiología y bioestadística::bioestadística::almacenamiento y recuperación de la información::registros de mortalidad [SALUD PÚBLICA], business.industry, Hazard ratio, Parenteral nutrition, Confidence interval, Intensive Care Units, terapéutica::métodos de alimentación::nutrición enteral [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Observational study, Health Surveillance of Health Services::Health Facilities::Hospitals::Hospital Units::Intensive Care Units [HEALTH SURVEILLANCE], business, Enteral nutrition
Abstract

Background: The importance of artificial nutritional therapy is underrecognized, typically being considered an adjunctive rather than a primary therapy. We aimed to evaluate the influence of nutritional therapy on mortality in critically ill patients.Methods: This multicenter prospective observational study included adult patients needing artificial nutritional therapy for >48 h if they stayed in one of 38 participating intensive care units for ≥72 h between April and July 2018. Demographic data, comorbidities, diagnoses, nutritional status and therapy (type and details for ≤14 days), and outcomes were registered in a database. Confounders such as disease severity, patient type (e.g., medical, surgical or trauma), and type and duration of nutritional therapy were also included in a multivariate analysis, and hazard ratios (HRs) and 95% confidence intervals (95%CIs) were reported.Results: We included 639 patients among whom 448(70.1%) and 191(29.9%) received enteral and parenteral nutrition, respectively. Mortality was 25.6%, with non-survivors having the following characteristics: older age; more comorbidities; higher Sequential Organ Failure Assessment (SOFA) scores (6.6±3.3 vs 8.4±3.7; P); greater nutritional risk (Nutrition Risk in the Critically Ill [NUTRIC] score: 3.8±2.1 vs 5.2±1.7; P); more vasopressor requirements (70.4% vs 83.5%; P=0.001); and more renal replacement therapy (12.2% vs 23.2%; P=0.001). Multivariate analysis showed that older age (HR: 1.023; 95% CI: 1.008–1.038; P=0.003), higher SOFA score (HR: 1.096; 95% CI: 1.036–1.160; P=0.001), higher NUTRIC score (HR: 1.136; 95% CI: 1.025–1.259; P=0.015), requiring parenteral nutrition after starting enteral nutrition (HR: 2.368; 95% CI: 1.168–4.798; P=0.017), and a higher mean Kcal/Kg/day intake (HR: 1.057; 95% CI: 1.015–1.101; P=0.008) were associated with mortality. By contrast, a higher mean protein intake protected against mortality (HR: 0.507; 95% CI: 0.263–0.977; P=0.042).Conclusions: Old age, higher organ failure scores, and greater nutritional risk appear to be associated with higher mortality. Patients who need parenteral nutrition after starting enteral nutrition may represent a high-risk subgroup for mortality due to illness severity and problems receiving appropriate nutritional therapy. Mean calorie and protein delivery also appeared to influence outcomes.Trial Registration: ClinicaTrials.gov NCT: 03634943.

Published
2022

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