Feeding the critically ill obese patient: a systematic review protocol

Area of Science:

• Critical care medicine
• Nutritional science
• Obesity research

Background:

• Obesity prevalence is increasing, with nearly 50% of intensive care unit (ICU) patients being obese.
• Critically ill obese patients present unique challenges due to comorbidities and altered metabolism.
• Early and adequate enteral nutrition is vital, yet often delayed or sub-optimal in obese ICU patients.

Purpose of the Study:

• To identify effective enteral nutritional regimens for critically ill obese patients.
• To determine optimal protein and calorie targets to improve mortality and morbidity.
• To systematically review existing literature on nutritional strategies for this population.

Main Methods:

• Systematic review of available literature.
• Evaluation of studies on enteral protein and calorie delivery.
• Analysis of nutritional regimens targeting critically ill obese patients.

Main Results:

• Evidence suggests a hypo-caloric, high-protein enteral feeding strategy may be beneficial.
• This approach aims to promote weight loss while preserving lean muscle mass and nitrogen balance.
• Current international practices show uniformly low calorie and protein delivery across BMI groups.

Conclusions:

• Optimal enteral nutrition targets for critically ill obese patients remain unclear.
• Further research is needed to establish evidence-based guidelines for protein and calorie delivery.
• A hypo-caloric, high-protein regimen warrants further investigation for improved outcomes.