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Sun Sep 6 00:41:55 BST 2009

I'm not aware of any trails that support 'entrocyte' feeding at  
20mls/h. EVerything I am aware of progresses to a reasonable (not  
hypocaloric) target at a reasonable rate.

If you focus just on trauma patients, the evidence is unconvincing. If  
you accept that all critically ill patients may have a similar  
response to nutrition, and accept valid answers may be obtained from  
meta-analysis, there is only one meta-analysis on the topic that  
demonstrates a moretality benefit:

Doig GS, Heighes PT, Simpson F, Sweetman EA and Davies AR. Enteral  
nutrition within 24 h of ICU admission significantly reduces  
mortality: A meta-analysis of RCTs. Intensive Care Medicine 2009  
(Accepted 12 Aug 2009, in press).

Gordon

Quoting "Dr Timothy Hardcastle" <dr.tchardcastle at absamail.co.za>:

> Dell
>
> Why not start by looking at the three recent consensus documents published
> as follows:
>
> Nutrition in trauma J Trauma Dec 2008 (from the inflammation group)
> Enteral nutrition in Critical illness co-published in Crit Care Med and
> ASPEN Journal Jan 2009
>
> -Check the references for RCT's.
>
> My understanding is that there are a number of level 2 trials that support
> at least enterosite support (semi-elimental @ about 20ml/hr) within 24
> hours, specifically in head injury.
>
> Tim
> Dr T C Hardcastle
> M.B., Ch.B. (Stell); M. Med. (Chir) (Stell); FCS (SA)
> Principal Specialist Trauma Surgeon /
> Honorary Lecturer University of KwaZulu-Natal Dept Surgery
> Deputy Director - IALCH Trauma Service
> Durban - South Africa
>>
>> Any data is appreciated
>>
>>
>>
>> Thanks.............Dell
>>
>>
>> -----Original Message-----
>> From: Robert Schulze <Robert.Schulze at nychhc.org>
>> To: trauma-list at trauma.org
>> Sent: Fri, Sep 4, 2009 10:52 am
>> Subject: Re: EARLY ENTERAL NUTRITION
>>
>>
>>
>>
>> I thought I remember a recent paper paper in JCCM , early enteral
>> nutrition in
>> head injury had better outcomes, will try to find reference.
>>
>> Robert Schulze MD FACS
>> SUNY Downstate/Kings County Hospital
>>
>>>>> <rwolfer at aol.com> 8/27/2009 6:37 PM >>>
>>
>> dont have any data but we are trying to do it.? would like to see if there
>> is
>> supporting data
>>
>> RW
>>
>>
>>
>> -----Original Message-----
>> From: moore677 at aol.com
>> To: trauma-list at trauma.org
>> Sent: Thu, Aug 27, 2009 6:23 pm
>> Subject: EARLY ENTERAL NUTRITION
>>
>>
>>
>> Is anyone aware of any Level I data that supports early (within 48 hours)
>> enteral nutrition in trauma or critically ill patients where outcomes,
>> mortality, LOS, etc. are improved?? I am an ardent supporter of feeding
>> the gut
>> ASAP and I am trying to find good data to support
>> this........................Dell
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EARLY ENTERAL NUTRITION