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Nutrition in the critically ill patient
Kristine W A C Koekkoek1, Arthur R H van Zanten
1Department of Intensive Care Medicine, Gelderse Vallei Hospital, Ede, The Netherlands.
Current Opinion in Anaesthesiology
|February 3, 2017
Summary
Optimal nutrition in critical illness focuses on body composition and protein intake. While enteral nutrition is preferred, recent studies suggest hypocaloric feeding with adequate protein is safe and effective, with probiotics aiding gut function recovery.
Area of Science:
- Critical care medicine
- Clinical nutrition
- Metabolic research
Background:
- Nutritional status is crucial for critically ill patients.
- Body composition impacts clinical outcomes.
- Accurate nutritional risk assessment is essential.
Purpose of the Study:
- To review recent studies on nutrition in critical illness.
- To provide evidence-based recommendations for clinical practice.
- To highlight advancements in nutritional support.
Main Methods:
- Systematic review of recent literature.
- Analysis of studies on nutritional status, body composition, and feeding strategies.
- Evaluation of evidence for enteral vs. parenteral nutrition, pharmaconutrition, and probiotics.
Main Results:
- Body composition, particularly lean body mass, correlates with outcomes.
- The modified NUTrition Risk in the Critically ill score aids risk assessment.
- Enteral nutrition is generally preferred, but parenteral nutrition shows no inferiority in some studies.
- Hypocaloric feeding with adequate protein may be beneficial.
- Probiotics can reduce infectious complications and improve gut function recovery.
Conclusions:
- Prioritize body composition and protein adequacy in critical care nutrition.
- Rethink gastric residual volume monitoring and tube placement strategies.
- Consider probiotics for reducing infectious complications and enhancing gut recovery.
- Individualize nutritional therapy based on risk assessment and patient status.
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