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Nutrition support in critical illness

R G Barton

    Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
    |August 1, 1994
    PubMed
    Summary
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    Critically ill patients with sepsis, shock, trauma, or burns experience severe metabolic changes. Nutrition support is crucial for managing these conditions and improving outcomes.

    Area of Science:

    • Critical care medicine
    • Metabolic disorders
    • Nutritional science

    Background:

    • Critically ill patients (sepsis, shock, trauma, burns) exhibit catabolism, lean body mass loss, immune dysfunction, and poor wound healing.
    • Nutrition support is a cornerstone of managing these complications in critical illness.

    Purpose of the Study:

    • Compare stress hypermetabolism and starvation metabolism.
    • Review current recommendations for energy and substrate provision in critically ill patients.
    • Evaluate enteral versus parenteral nutrition.
    • Overview new and future therapies, including substrates and growth factors.

    Main Methods:

    • Literature review and synthesis of current evidence.
    • Comparative analysis of metabolic states.

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  • Evaluation of nutritional support modalities.

    • Main Results:

    • Stress hypermetabolism and starvation metabolism present distinct metabolic profiles.
    • Current guidelines emphasize tailored energy and substrate delivery.
    • Enteral nutrition is generally preferred when feasible.
    • Emerging therapies show potential for modulating metabolic response.

    Conclusions:

    • Optimizing nutrition is vital for mitigating complications in critically ill patients.
    • Understanding metabolic differences guides therapeutic strategies.
    • Future research should focus on novel substrates and growth factors for enhanced recovery.