Nutrition recovery after critical illness: toward a personalized, multimodal approach

Although survival after critical illness has improved, many intensive care unit (ICU) survivors experience persistent muscle wasting, malnutrition and functional decline - all of which are key components of postintensive care syndrome (PICS). This review discusses the metabolic and nutritional challenges faced after ICU discharge, explaining why addressing these issues through personalized recovery strategies is both timely and clinically relevant.

Recent evidence shows that ICU survivors typically achieve 50-60% of their energy and protein requirements during the recovery phase, particularly after transfer from the ICU to the ward. As, the energy expenditure remains elevated, the energy imbalance may worsen after discharge from the ICU. Factors contributing to this imbalance include hypercatabolism, dysphagia, immobilization and hormonal disturbances. Emerging studies suggest that phased, personalized nutrition, guided by dietitians and supported by early mobilization and metabolic monitoring, can improve outcomes. Research has shown that personalized nutritional support reduces mortality and complications in hospitalized patients.

Optimizing nutrition from the ICU through to posthospital recovery is essential for restoring muscle mass, reducing disability and enhancing quality of life. Multimodal, personalized nutrition strategies combined with rehabilitation are the cornerstone of post-ICU recovery and should be a major focus of future clinical research and implementation.