A lifetime of research on nutrition in critical illness – Professor Daren Heyland Artwork

Asia Ventilation Forum

The Asia Ventilation Forum (AVF) is a not-for-profit organisation comprising members from different Asian countries. We share our knowledge and experience in respiratory care and critical care with intensive care unit (ICU) workers across the continent with the aim of improving care and outcomes for the critically ill. There are two AVF Podcast series. "Behind-The-Scenes ICU Stories" invites colleagues to share anything and everything on their personal experiences. Expect heart-to-heart discussions on topics that may or may not have been widely described in the medical literature. "The Challenges of Airway Management During the Pandemic" invites colleagues to share anything and everything on how they deal with various clinical situations. Expect discussions on how experts personalise evidence-based medicine for the patient at the bedside. These Podcasts are hosted by Dr Jason Phua, respiratory physician and intensivist at Alexandra Hospital, National University Health System, Singapore, and Dr Jose Emmanuel Palo, intensivist at The Medical City, the Philippines.

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Asia Ventilation Forum

A lifetime of research on nutrition in critical illness – Professor Daren Heyland

April 03, 2023 • AVF • Season 1 • Episode 27

In this AVF Podcast: Behind-The-Scenes ICU Stories episode, Dr Daren Heyland shares key takeaways from large-scale randomised trials on critical care nutrition led by him and published in the last year, a culmination of his impressive career. Dr Heyland is a Professor of Medicine and Epidemiology at Queen’s University, Kingston, Ontario Canada. He is trained in internal medicine, critical care medicine, and clinical epidemiology. He currently serves as the Director of the Clinical Evaluation Research Unit at the Kingston General Hospital. Overall, Dr Heyland has published approximately 450 peer-reviewed papers, raised more than $120 million in external grant support, and given more than 350 international presentations.

Issues discussed in this interview:

· What inspired Dr Heyland to do research in nutrition in critical illness

· The RE-ENERGIZE trial on enteral glutamine for burn injuries (NEJM 2022)

· The SUSTAIN CSX trial on high-dose selenium for cardiac surgery (JAMA Surgery 2023)

· The LOVIT trial on intravenous vitamin C for sepsis (NEJM 2022)

· The EFFORT Protein trial on higher protein dosing for critical illness (Lancet 2023)

· Future areas for research in nutrition in critical illness?

· Thoughts on clinical trial designs for the future

· Reflections on Dr Heyland’s life’s work

Selected further reading:

1. Heyland DK, Wibbenmeyer L, Pollack JA, et al. A randomized trial of enteral glutamine for treatment of burn injuries. N Engl J Med 2022;387:1001-1010.

2. Stoppe C, McDonald B, Meybohm P, et al. Effect of high-dose selenium on postoperative organ dysfunction and mortality in cardiac surgery patients: the SUSTAIN CSX randomized clinical trial. JAMA Surg 2023;158:235-244.

3. Lamontagne F, Masse MH, Menard J, et al. Intravenous vitamin C in adults with sepsis in the intensive care unit. N Engl J Med 2022;386:2387-2398.

4. Heyland DK, Patel J, Compher C, et al. The effect of higher protein dosing in critically ill patients with high nutritional risk (EFFORT Protein): an international, multicentre, pragmatic, registry-based randomised trial. Lancet.2023;401:568-576.

5. Lee ZY, Ortiz-Reyes L, Lew CCH, et al. Intravenous vitamin C monotherapy in critically ill patients: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis. Ann Intensive Care 2023;13:14.