EuroPN Study: New Clinical Data on Medical Nutrition Therapy in Critically Ill Patients

Early medical nutrition therapy with moderate daily calorie and protein intakes* is associated with improved clinical outcomes in critically ill patients. This is shown by new data from the EuroPN Study which was published last week in Critical Care.¹

The study is part of the “United for Clinical Nutrition” initiative. Fresenius Kabi, a leading provider of clinical nutrition, founded this global initiative in 2014 to raise awareness for medical nutrition therapy as well as to overcome hospital malnutrition and its effects on patients around the world. The EuroPN Study is one of the largest prospective studies providing real-world evidence about nutrition and its associations with clinical outcomes in a mixed population of critically ill adult patients treated in European intensive care units (ICUs) for a minimum ICU length of stay of 5 days.¹

Critically ill patients benefit from moderate daily calorie and protein intakes

The study examined the impact of early medical nutrition therapy on clinical outcomes in critical care. During intensive care, patients’ medical nutrition therapy was started on median day 2 after ICU admission and was progressively increased as recommended by the ESPEN ICU guidelines.^1,2 Overall, 83% of patients’ ESPEN calorie targets and 65% of their ESPEN protein targets were met.¹

"In our study, we saw clinical outcome advantages with a daily calorie intake of 10-20 kcal/kg and a protein intake of 0.8-1.2 g/kg body weight" explains Dr. Clara Vaquerizo, study investigator from the Department of Intensive Care Medicine, Fuenlabrada University Hospital, Madrid. Weaning from invasive mechanical ventilation (IMV) was earlier in patients with early moderate energy and protein intakes, compared to patients who received lower or higher daily intakes.¹ In addition, the EuroPN data showed that patients who received daily 10-20 kcal/kg body weight had a significantly lower 90-day mortality risk compared to lower intake.¹

The majority of critically ill patients do not receive adequate nutritional intake according to guideline targets.^3,4 “Currently, there is no study assessing the level of adherence to the latest ESPEN ICU recommendations. This study is very helpful to characterize clinical nutrition strategies relevant to patient outcomes” explains Prof. Dr. Martin Westphal, Head of Medical Department, Business Unit Nutrition, Chief Medical Officer and Executive Vice President at Fresenius Kabi.

77 hospitals in 11 European countries

In the prospective multinational cohort study, 1,172 critically ill patients who required intensive care for at least 5 consecutive days were enrolled. 77 ICUs in 11 European countries (Austria, Belgium, Czech Republic, France, Germany, Hungary, Italy, Poland, Spain, Sweden, and the United Kingdom) participated.¹

* 10-20 kcal/kg body weight per day, 0.8-1.2 g protein/kg body weight per day

References:

1. Matejovic, M, Huet, O, Dams, K, et al. Medical nutrition therapy and clinical outcomes in critically ill adults: a European multinational, prospective observational cohort study (EuroPN). Critical Care. 2022;26(143). https://doi.org/10.1186/s13054-022-03997-z
2. Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clinical Nutrition. 2019;38(1):48–79.
3. Heyland DK, Dhaliwal R, Wang M, Day AG. The prevalence of iatrogenic underfeeding in the nutritionally ‘at-risk’critically ill patient: Results of an international, multicenter, prospective study. Clinical Nutrition. 2015;34(4):659-666.
4. Vallejo KP, Martínez CM, Adames AAM, et al. Current clinical nutrition practices in critically ill patients in Latin America: a multinational observational study. Critical Care. 2017;21(1):1-11.

Fresenius Kabi is a global healthcare company that specializes in lifesaving medicines and technologies for infusion, transfusion and clinical nutrition. The company’s products and services are used to help care for critically and chronically ill patients. Fresenius Kabi’s product portfolio comprises a comprehensive range of I.V. generic drugs, infusion therapies and clinical nutrition products as well as the devices for administering these products. In the field of biosimilars, Fresenius Kabi focuses on autoimmune diseases and oncology. In 2019, the first biosimilar product by Fresenius Kabi was launched. Within transfusion medicine and cell therapies, Fresenius Kabi offers products for collection of blood components and extracorporeal therapies.

With its corporate mission of "caring for life", the company is committed to putting essential medicines and technologies in the hands of people who help patients and finding the best answers to the challenges they face.

Fresenius Kabi employs more than 41,000 people worldwide. In 2021, the company reported sales of more than €7.1 billion. Fresenius Kabi AG is a wholly owned subsidiary of the Fresenius SE & Co. KGaA healthcare group.

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