EPaNIC
Early versus Late Initiation of Parenteral Nutrition
Patient / Population Intervention / Exposure Comparison Outcome
In 4,640 ICU patients with insufficient enteral intake, late parenteral nutrition (after day 7) accelerated live ICU discharge compared with early parenteral nutrition.
N
4,640
Design
Multicentre RCT, Belgium
Endpoint
Time to live discharge from the ICU
Relevance
2
ResultHR 1.06 for earlier discharge (p=0.04); fewer infections; less RRT.
Casaer MP, et al. N Engl J Med. 2011;365(6):506-517. 10.1056/NEJMoa1102662
Discussion & critique
Avoid early supplemental PN; let permissive underfeeding ride for the first week.