Whether fasting early in critical illness course is acceptable is not clear and high-quality data on this topic is lacking. In order to generate equipoise for future clinical trials and bring additional data to current literature, we compared outcomes of patients fasted during the first 72 hours of ICU stay to patients receiving any nutritional support during this period.
Retrospective cohort study of a medical ICU from a tertiary Academic center in Brazil. Adult patients treated between November 2017 and February 2022 with an ICU length of stay of five days or more were included. Baseline and daily data were retrieved from the prospectively collected administrative database. We did 1:1 propensity score matching to compare patients fasting for at least 72 hours with controls. Primary outcome was hospital mortality and secondary outcomes were other resources’ utilization.
During the study period, 1591 patients were cared for in this ICU, of which 998 stayed five days or more. After excluding readmissions and propensity score matching, 93 patients in the fasting group were matched to 93 controls. Hospital mortality was similar between fasting and matched control groups (OR = 1.04, 95% CI = 0.56 – 1.94, p > 0.99). Secondary outcomes were not different between groups, including length of stay, days on mechanical ventilation, and incidence of new infections.
Withholding nutritional support in the first 72h of ICU stay was not associated with worst outcomes in this cohort of severe critically ill patients This article is protected by copyright. All rights reserved.
Critical care; Enteral nutrition; Nutrition; Nutrition Support Practice; Research and Diseases.