The role of supplemental parenteral nutrition in hospitalised patients. Clinical nutrition remains a cornerstone of the treatment of critically ill, with impact on morbidity and mortality. Nevertheless, iatrogenic malnutrition remains a fact, with energy and protein intake which differs from European, American or Canadian recommendations. Guided by the physical condition of the patient, different treatment modalities are available, including supplemental parenteral nutrition. As it is proven that in an ICU setting, PN and Enteral Nutrition have the same outcome, the route of artificial nutrition does not really matter anymore. Correct dosing, energy guided by indirect calorimetry, and protein on body weight, is of cardinal importance. In a meta-analysis, the use of SPN significantly decreased infection rates. Large agreement exists about the positive contribution of SPN to feeding adequacy. In a post ICU state, but also in surgical, gastro-intestinal or oncological conditions, SPN can make the difference. Further research is needed to ensure a safe use and optimise the use, but succes is already warranted when used in an optimal way.
Elisabeth De Waele is head of the 2021 newly created Department of Clinical Nutrition at Universitair Ziekenhuis Brussel which unites medical doctors, dietitians, pharmacists and nurses who take care of hospitalized and ambulatory patients challenged by nutritional and metabolic issues. She is associated with the Intensive Care Department and with the Vrije Universiteit Brussel and Erasmus Hogeschool Brussel where she teaches pharmacists and dietitians in training. Since 2018 she is Member of the Executive Board of the European Society for Clinical Nutrition and Metabolism. She is an active member of the Metabolism and Nutrition Section of the European Society of Intensive Care Medicine and Member of the Faculty of the International Symposium on Intensive Care & Emergency Medicine. She graduated with great distinction from Vrije Universiteit Brussel in 2004, completed postgraduate training in general surgery in 2010 and became a certified Intensive Care Physician in 2012. In 2008 she obtained a Bachelor diploma in Clinical Nutrition (Odisee Graduate School). Her scientific work is focused on clinical research in metabolism and nutrition in critically ill, cancer and surgical patients and resulted in a PhD Thesis entitled “Energy Expenditure and Nutritional Therapy in Critically ill Patients” in 2015. She acts as a principal investigator in 9 studies and numerous times as a co-investigator. Professor De Waele has published 100 articles in peer-reviewed journals and has an extended experience in lecturing live and virtual at international and national symposia (over 100 performances) and also dedicates here time to communicate to a non-medical audience