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Nutritional considerations in the critically ill.

A Barrocas, G L Webb, W R Webb

    Southern Medical Journal
    |July 1, 1982
    PubMed
    Summary
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    Critically ill patients require immediate nutritional assessment and support. Prioritizing gastrointestinal (GI) tract feeding over intravenous nutrition minimizes complications and supports recovery.

    Area of Science:

    • Critical Care Medicine
    • Nutritional Support
    • Metabolism

    Background:

    • Nutritional status is crucial for critically ill patients from illness onset.
    • Protein is essential but can be depleted for gluconeogenesis during stress or starvation.
    • Bedside nutritional assessment techniques are vital for intensive care providers.

    Purpose of the Study:

    • To review essential nutritional assessment and support strategies for critically ill patients.
    • To emphasize the importance of utilizing the gastrointestinal (GI) tract for nutrition.
    • To highlight considerations for avoiding complications such as CO2 overload.

    Main Methods:

    • Review of current literature on nutritional assessment in critical care.
    • Discussion of various nutritional support modalities.

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  • Emphasis on the use of enteral nutrition over parenteral nutrition.
  • Consideration of respiratory implications of nutritional support.

    • Main Results:

    • Simple bedside assessment techniques for nutritional status are available.
    • Optimal nutritional support should be a standard in intensive care.
    • Enteral nutrition is preferred to avoid complications associated with intravenous nutrition.
    • Nutritional support must consider potential CO2 overload in patients with respiratory compromise.

    Conclusions:

    • Comprehensive care for critically ill patients includes early nutritional attention.
    • The GI tract should be used preferentially for nutritional support.
    • A team approach is essential for prioritizing nutritional versus pulmonary support.
    • Further knowledge in this evolving field of critical care nutrition is encouraged.