How to Feed Critically Ill Patients

Nutrition therapy is challenging in critically ill patients. Critical illness is associated with catabolic stress, in which stress hormones and inflammatory mediators are activated, resulting in proteolysis. The goals of nutrition therapy in critically ill patients are to preserve lean body mass, to...

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Main Author: Suk-Kyung Hong
Format: Article
Language:English
Published: Korean Society of Acute Care Surgery 2015-04-01
Series:Journal of Acute Care Surgery
Subjects:
Online Access:http://www.jacs.or.kr/upload/pdf/jacs-5-1.pdf
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author Suk-Kyung Hong
author_facet Suk-Kyung Hong
author_sort Suk-Kyung Hong
collection DOAJ
description Nutrition therapy is challenging in critically ill patients. Critical illness is associated with catabolic stress, in which stress hormones and inflammatory mediators are activated, resulting in proteolysis. The goals of nutrition therapy in critically ill patients are to preserve lean body mass, to preserve immune function, and to avoid metabolic complications. Limited physiologic reserves mandate a comprehensive approach and monitoring. Enteral nutrition is preferred over parenteral nutrition unless the patient is hemodynamically stable and enteral feeding is contraindicated. Early enteral nutrition is recommended within 24 to 48 hours of intensive care unit admission. If enteral nutrition is not feasible within several days, supplementary parenteral nutrition is necessary. In the acute phase, energy requirements should be less than 20 to 25 kcal/kg/day; in the recovery phase, more than 30 to 35 kcal/kg/day. Protein should be supplemented in the range of 1.2 to 2.0 g/kg/day. Monitoring for tolerance of enteral nutrition to avoid complications is very important in critically ill patients. An immune modulating effect of immunonutritional components such as glutamine or omega-3 fatty acids can occur in specific diseases. In conclusion, comprehensive nutrition therapy plays an important role in clinical outcomes.
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spelling doaj.art-a6c4fad8f611470abbaaaa6b115fed352023-09-18T06:08:21ZengKorean Society of Acute Care SurgeryJournal of Acute Care Surgery2288-58622288-95822015-04-01511610.17479/jacs.2015.5.1.12How to Feed Critically Ill PatientsSuk-Kyung Hong0 Department of Surgery, University of Ulsan College of Medicine, Seoul, Korea Nutrition therapy is challenging in critically ill patients. Critical illness is associated with catabolic stress, in which stress hormones and inflammatory mediators are activated, resulting in proteolysis. The goals of nutrition therapy in critically ill patients are to preserve lean body mass, to preserve immune function, and to avoid metabolic complications. Limited physiologic reserves mandate a comprehensive approach and monitoring. Enteral nutrition is preferred over parenteral nutrition unless the patient is hemodynamically stable and enteral feeding is contraindicated. Early enteral nutrition is recommended within 24 to 48 hours of intensive care unit admission. If enteral nutrition is not feasible within several days, supplementary parenteral nutrition is necessary. In the acute phase, energy requirements should be less than 20 to 25 kcal/kg/day; in the recovery phase, more than 30 to 35 kcal/kg/day. Protein should be supplemented in the range of 1.2 to 2.0 g/kg/day. Monitoring for tolerance of enteral nutrition to avoid complications is very important in critically ill patients. An immune modulating effect of immunonutritional components such as glutamine or omega-3 fatty acids can occur in specific diseases. In conclusion, comprehensive nutrition therapy plays an important role in clinical outcomes.http://www.jacs.or.kr/upload/pdf/jacs-5-1.pdfcritical illnessnutrition therapyenteral nutritionglutamineomega-3 fatty acids
spellingShingle Suk-Kyung Hong
How to Feed Critically Ill Patients
Journal of Acute Care Surgery
critical illness
nutrition therapy
enteral nutrition
glutamine
omega-3 fatty acids
title How to Feed Critically Ill Patients
title_full How to Feed Critically Ill Patients
title_fullStr How to Feed Critically Ill Patients
title_full_unstemmed How to Feed Critically Ill Patients
title_short How to Feed Critically Ill Patients
title_sort how to feed critically ill patients
topic critical illness
nutrition therapy
enteral nutrition
glutamine
omega-3 fatty acids
url http://www.jacs.or.kr/upload/pdf/jacs-5-1.pdf
work_keys_str_mv AT sukkyunghong howtofeedcriticallyillpatients