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Nutrition Therapy in Sepsis
1Department of Anesthesiology, Duke University School of Medicine, 2400 Pratt Street, Office: NP 7060, Durham, NC 27705, USA.
Critical Care Clinics
|November 19, 2017
Summary
Sepsis causes significant lean body mass loss and hypermetabolism. Early enteral nutrition, followed by increased protein and calories, is crucial for recovery and preventing further muscle loss.
Area of Science:
- Critical care medicine
- Nutritional science
- Metabolic disorders
Background:
- Sepsis induces profound catabolism and hypermetabolism, leading to lean body mass (LBM) loss.
- This metabolic derangement can persist for extended periods, impacting long-term recovery.
- Nutritional status significantly influences patient outcomes in sepsis.
Purpose of the Study:
- To outline optimal nutritional strategies for sepsis management.
- To emphasize the importance of early and sustained nutritional support.
- To guide the use of enteral and parenteral nutrition in septic patients.
Main Methods:
- Review of current literature on sepsis and nutrition.
- Analysis of metabolic changes during and after sepsis.
- Guidelines for protein and calorie delivery based on patient condition.
Main Results:
- Early enteral nutrition should address micronutrient deficiencies and provide adequate protein and calories.
- Post-resuscitation, increased protein and calorie intake is necessary to mitigate LBM loss.
- Malnutrition screening is vital; parenteral nutrition is a safe adjunct when enteral feeding is insufficient.
Conclusions:
- Optimizing nutrition is critical for attenuating LBM loss and promoting recovery in sepsis.
- A phased nutritional approach, from early enteral to increased post-ICU intake, is essential.
- Personalized nutritional support, including consideration of parenteral nutrition, improves functional and LBM recovery.
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