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Full Nutrition or Not?

Mary F Stuever1, Ryan F Kidner1, Floria E Chae1

  • 1Department of Surgery, Division of Trauma, Critical Care and Burn, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
|June 8, 2018
PubMed
Summary
This summary is machine-generated.

Optimal enteral nutrition (EN) in critical care requires patient-specific assessment. Full nutrition support is vital for high-risk patients, while trophic strategies may suit others, balancing energy and protein delivery.

Keywords:
autophagycritical illnessenteral nutritionimmune systemimmunonutritionnutrition supportsystemic inflammatory response syndrome

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Area of Science:

  • Critical care medicine
  • Clinical nutrition
  • Intensive care unit (ICU) management

Background:

  • Enteral nutrition (EN) is standard in ICUs, but optimal dosing in early critical illness remains debated.
  • Conflicting evidence exists regarding trophic vs. permissive/intentional underfeeding strategies.
  • Unintentional underdelivery and increasing protein recommendations complicate EN decisions.

Purpose of the Study:

  • To review current evidence on EN dosing strategies in the first week of critical illness.
  • To explore patient-specific factors influencing optimal EN delivery.
  • To discuss the roles of autophagy and immunonutrition in EN selection.

Main Methods:

  • Systematic review of key clinical trials on EN in early critical illness.
  • Analysis of factors influencing nutrition risk and demand.
  • Discussion of emerging concepts like autophagy and immunonutrition.

Main Results:

  • Evidence for full EN vs. underfeeding strategies is conflicting.
  • Patient-specific assessment is crucial for effective EN.
  • High-risk patients (wounds, surgery, burns) may benefit from full EN.
  • Medical patients (e.g., ARDS) might be suited for trophic strategies.

Conclusions:

  • Personalized EN strategies are essential for critically ill patients.
  • Accurate assessment of nutrition risk and demand guides optimal EN delivery.
  • Further research into autophagy and immunonutrition may refine EN protocols.