{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T09:40:07Z","timestamp":1793094007848,"version":"4.5.0"},"reference-count":27,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T00:00:00Z","timestamp":1698969600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Spanish Society of Metabolism and Nutrition (SENPE: Sociedad Espa\u00f1ola de Nutrici\u00f3n y Metabolismo)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Parenteral nutrition (PN) is needed to avoid the development of malnutrition when enteral nutrition (EN) is not possible. Our main aim was to assess the current use, complications, and nutrition delivery associated with PN administration in adult critically ill patients, especially when used early and as the initial route. We also assessed the differences between patients who received only PN and those in whom EN was initiated after PN (PN-EN). Methods: A multicenter (n = 37) prospective observational study was performed. Patient clinical characteristics, outcomes, and nutrition-related variables were recorded. Statistical differences between subgroups were analyzed accordingly. Results: From the entire population (n = 629), 186 (29.6%) patients received PN as initial nutrition therapy. Of these, 74 patients (11.7%) also received EN during their ICU stay (i.e., PN-EN subgroup). PN was administered early (&lt;48 h) in the majority of patients (75.3%; n = 140) and the mean caloric (19.94 \u00b1 6.72 Kcal\/kg\/day) and protein (1.01 \u00b1 0.41 g\/kg\/day) delivery was similar to other contemporary studies. PN showed similar nutritional delivery when compared with the enteral route. No significant complications were associated with the use of PN. Thirty-two patients (43.3%) presented with EN-related complications in the PN-EN subgroup but received a higher mean protein delivery (0.95 \u00b1 0.43 vs 1.17 \u00b1 0.36 g\/kg\/day; p = 0.03) compared with PN alone. Once adjusted for confounding factors, patients who received PN alone had a lower mean protein intake (hazard ratio (HR): 0.29; 95% confidence interval (CI): 0.18\u20130.47; p = 0.001), shorter ICU stay (HR: 0.96; 95% CI: 0.91\u20130.99; p = 0.008), and fewer days on mechanical ventilation (HR: 0.85; 95% CI: 0.81\u20130.89; p = 0.001) compared with the PN-EN subgroup. Conclusion: The parenteral route may be safe, even when administered early, and may provide adequate nutrition delivery. Additional EN, when possible, may optimize protein requirements, especially in more severe patients who received initial PN and are expected to have longer ICU stays. NCT Registry: 03634943.<\/jats:p>","DOI":"10.3390\/nu15214665","type":"journal-article","created":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T10:59:54Z","timestamp":1699009194000},"page":"4665","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Parenteral Nutrition: Current Use, Complications, and Nutrition Delivery in Critically Ill Patients"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3324-1129","authenticated-orcid":false,"given":"Juan Carlos","family":"Lopez-Delgado","sequence":"first","affiliation":[{"name":"Hospital Clinic, Medical ICU, Clinical Institute of Internal Medicine & Dermatology (ICMiD), C\/Villarroel, 170, 08036 Barcelona, Spain"},{"name":"IDIBELL (Biomedical Investigation Institute of Bellvitge), Av. de la Gran Via, 199, 08908 L\u2019Hospitalet de Llobregat, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodoro","family":"Grau-Carmona","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital 12 de Octubre, Av. de C\u00f3rdoba s\/n, 28041 Madrid, Spain"},{"name":"i+12 (Research Institute Hospital 12 de Octubre), Av. de C\u00f3rdoba s\/n, 28041 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Mor-Marco","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital Universitario Germans Trias i Pujol, Carretera de Canyet, s\/n, 08916 Badalona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4129-7309","authenticated-orcid":false,"given":"Maria Luisa","family":"Bordeje-Laguna","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital Universitario Germans Trias i Pujol, Carretera de Canyet, s\/n, 08916 Badalona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Portugal-Rodriguez","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital Cl\u00ednico Universitario de Valladolid, Av. Ram\u00f3n y Cajal, 3, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9237-5541","authenticated-orcid":false,"given":"Carol","family":"Lorencio-Cardenas","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital Universitari Josep Trueta, Av. de Fran\u00e7a, s\/n, 17007 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3346-5093","authenticated-orcid":false,"given":"Paula","family":"Vera-Artazcoz","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital de la Santa Creu i Sant Pau, C\/Sant Quint\u00ed, 89, 08041 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Macaya-Redin","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Complejo Hospitalario de Navarra, C\/Irunlarrea, E, 31008 Pamplona, Navarra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Llorente-Ruiz","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital Universitario Pr\u00edncipe de Asturias, Av. Principal de la Universidad, s\/n, 28805 Alcal\u00e1 de Henares, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayden","family":"Iglesias-Rodriguez","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital General de Granollers, C\/Francesc Ribas, s\/n, 08402 Granollers, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9691-2466","authenticated-orcid":false,"given":"Diana","family":"Monge-Donaire","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital Virgen de la Concha, Av. Requejo, 35, 49022 Zamora, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Francisco","family":"Martinez-Carmona","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital Regional Universitario Carlos Haya, Av. de Carlos Haya, 84, 29010 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Sanchez-Ales","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital de Terrassa, C\/Torrebonica, s\/n, 08227 Terrassa, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel","family":"Sanchez-Miralles","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital Universitari Sant Joan d\u2019Alacant, N-332, s\/n, 03550 Sant Joan d\u2019Alacant, Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Crespo-Gomez","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital Doctor Peset, Av. Gaspar Aguilar, 90, 46017 Valecia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Leon-Cinto","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital Royo Villanova, Av. San Gregorio, s\/n, 50015 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6941-7574","authenticated-orcid":false,"given":"Jose Luis","family":"Flordelis-Lasierra","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital 12 de Octubre, Av. de C\u00f3rdoba s\/n, 28041 Madrid, Spain"},{"name":"i+12 (Research Institute Hospital 12 de Octubre), Av. de C\u00f3rdoba s\/n, 28041 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9513-1465","authenticated-orcid":false,"given":"Lluis","family":"Servia-Goixart","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital Universitari Arnau de Vilanova, Av. Alcalde Rovira Roure, 80, 25198 Lleida, Spain"},{"name":"IRBLLeida (Lleida Biomedical Research Institute\u2019s Dr. Pifarr\u00e9 Foundation), Av. Alcalde Rovira Roure, 80, 25198 Lleida, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the ENPIC Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1177\/0148607115625638","article-title":"Association Between Malnutrition and Clinical Outcomes in the Intensive Care Unit: A Systematic Review","volume":"41","author":"Lew","year":"2017","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_2","first-page":"33","article-title":"Recommendations for specialized nutritional-metabolic management of the critical patient: Indications, timing and access routes. Metabolism and Nutrition Working Group of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC)","volume":"44","year":"2020","journal-title":"Med. 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