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Nutrition support in patients with multiple organ failure
1University of Department of Anaesthesia and Intensive Care Unit, Withington Hospital, Manchester, UK.
Current Opinion in Clinical Nutrition and Metabolic Care
|November 24, 1999
Summary
Feeding patients with multiple organ failure is challenging due to inflammation, which prevents conventional nutritional support from maintaining muscle mass. Current nutritional and immune markers are unreliable because of fluid retention and the body's metabolic response to critical illness.
Area of Science:
- Critical Care Medicine
- Nutritional Support
- Immunology
Background:
- Patients in multiple organ failure experience an inflammatory process that hinders lean tissue mass preservation.
- Conventional nutritional support methods are often ineffective in critically ill patients.
- Standard markers for nutritional and immune status are compromised by fluid overload and metabolic changes.
Purpose of the Study:
- To investigate the challenges of nutritional support in patients with multiple organ failure.
- To understand the inflammatory response and protein breakdown in critical illness.
- To explore methods for favorably modifying the inflammatory response in these patients.
Main Methods:
- Review of recent research focusing on inflammatory processes in critical illness.
- Analysis of protein catabolism in sepsis and multiple organ failure.
- Examination of conventional anthropometric, visceral protein, and immunological markers.
Main Results:
- Inflammation in multiple organ failure prevents conventional nutrition from maintaining lean body mass.
- Fluid retention (5-15 L) and metabolic responses confound standard nutritional and immunological assessments.
- Protein breakdown is a significant issue in sepsis and multiple organ failure.
Conclusions:
- Effective nutritional strategies for multiple organ failure require addressing the underlying inflammatory state.
- Rethinking nutritional assessment and support is crucial for critically ill patients.
- Further research into modulating inflammatory responses may improve patient outcomes.