Critical Care Nutrition: Where's the Evidence?

Area of Science:

• Critical care medicine
• Surgical nutrition
• Metabolic response

Background:

• Critically ill surgical patients exhibit complex metabolic responses impacting immunity, wound healing, and muscle mass.
• Nutrition support has evolved into nutrition therapy to mitigate these detrimental effects.

Purpose of the Study:

• To review the metabolic response to critical illness in surgical patients.
• To describe nutritional risk assessment.
• To evaluate evidence for enteral and parenteral nutrition and immunonutrition in surgical intensive care units.

Main Methods:

• Literature review of metabolic response to critical illness.
• Analysis of evidence for nutritional interventions.
• Review of immunonutrition in surgical intensive care.

Main Results:

• The metabolic response to critical illness is variable and complex.
• Nutrition therapy aims to prevent cell injury, modulate immunity, and attenuate metabolic response.
• Evidence for optimal role, dose, and timing of nutrition support is reviewed.

Conclusions:

• Optimizing nutrition therapy is crucial for surgical critically ill patients.
• Evidence supports the role of enteral and parenteral nutrition and immunonutrition.
• Further research may refine timing and dosing of interventions.