ArticleIntensive care medicine2015
Impact of early nutrition and feeding route on outcomes of mechanically ventilated patients with shock: a post hoc marginal structural model study.
Article in Intensive care medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 70 citations in OpenAlex.
- Risk factors and outcomes of ventilator-associated pneumonia: an updated systematic review and meta-analysis.BMC pulmonary medicine · 2025Pooled it
- Intermittent vs. continuous: a comparative narrative review of enteral and parenteral nutrition support strategies in the perioperative setting.European journal of clinical nutrition · 2026Review
- OSCARinED: a policy and practice review of an emergency department-based critical care framework for critically ill non-trauma patients.Frontiers in medicine · 2026Article
- Intestinal Drug Absorption After Subarachnoid Hemorrhage and Elective Neurosurgery: Insights From Esomeprazole Pharmacokinetics.Critical care medicine · 2025Observational
- Treatment and Management ofInfection and drug resistance · 2024Review
- Impact of early enteral nutrition on ventilator associated pneumonia in intubated severe trauma patients: A propensity score-matched study.Frontiers in nutrition · 2023Article
- Covid 19: Diet Composition and Health.Nutrients · 2021Review
- Article
- Pathophysiology and protective approaches of gut injury in critical illness.Yeungnam University journal of medicine · 2021Article
- Nutritional Support in Coronavirus 2019 Disease.Medicina (Kaunas, Lithuania) · 2020Review
- Impact of nutrition route on microaspiration in critically ill patients with shock: a planned ancillary study of the NUTRIREA-2 trial.Critical care (London, England) · 2019Article
- Effects of semi-solidification of enteral nutrients on the pharmacokinetic behavior of orally administered carbamazepine in rats.International journal of medical sciences · 2019Article
- Relationship between microaspiration of gastric contents and ventilator-associated pneumonia.Annals of translational medicine · 2018Article
- Major Predictors of Incidence of Congestive Heart Failure and the Responsive Character of Enteral Nutrition: Meta-Analysis.Cardiology research · 2018Article
- Optimal timing, dose and route of early nutrition therapy in critical illness and shock: the quest for the Holy Grail.Intensive care medicine · 2018Article
- Editorial on "enteral versus parenteral early nutrition in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2)".Journal of thoracic disease · 2018Article
- Ten ineffective interventions to prevent ventilator-associated pneumonia.Intensive care medicine · 2018Article
- The Effects of Gastrointestinal Function on the Incidence of Ventilator-associated Pneumonia in Critically Ill Patients.Open medicine (Warsaw, Poland) · 2018Article
- Update on ventilator-associated pneumonia.F1000Research · 2017Review
- Article
Corrections and comments
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Authors and funding
20 authors at 10 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeFew data are available about optimal nutrition modalities in mechanically ventilated patients with shock. Our objective was to assess associations linking early nutrition (<48 h after intubation), feeding route and calorie intake to mortality and risk of ventilator-associated pneumonia (VAP) in patients with invasive mechanical ventilation (IMV) and shock.
methodsIn the prospective OutcomeRea database, we identified adults with IMV >72 h and shock (arterial systolic pressure <90 mmHg) within 48 h after intubation. A marginal structural Cox model was used to create a pseudo-population in which treatment was unconfounded by subject-specific characteristics.
resultsWe included 3,032 patients. Early nutrition was associated with lower day-28 mortality [HR 0.89, 95 % confidence interval (CI) 0.81-0.98, P = 0.01] and day-7 mortality (HR 0.76, CI 0.66-0.87, P < 0.001) but not with lower day-7 to day-28 mortality (HR 1.00, CI 0.89-1.12, P = 0.98). Early nutrition increased VAP risk over the 28 days (HR 1.08, CI 1.00-1.17, P = 0.046) and until day 7 (HR 7.17, CI 6.27-8.19, P < 0.001) but decreased VAP risk from days 7 to 28 (HR 0.85, CI 0.78-0.92, P < 0.001). Compared to parenteral feeding, enteral feeding was associated with a slightly increased VAP risk (HR 1.11, CI 1.00-1.22, P = 0.04) but not with mortality. Neither mortality nor VAP risk differed between early calorie intakes of ≥20 and <20 kcal/kg/day.
conclusionIn mechanically ventilated patients with shock, early nutrition was associated with reduced mortality. Neither feeding route nor early calorie intake was associated with mortality. Early nutrition and enteral feeding were associated with increased VAP risk.
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