TY - CHAP M1 - Book, Section TI - Nutrition A1 - Collo Go, Ronaldo A2 - Go, Ronaldo Collo Y1 - 2019 N1 - T2 - Critical Care Examination and Board Review AB - Critical illness is associated with a systemic inflammatory response and catabolic state that leads to increased infections, multiorgan dysfunction, prolonged hospitalization, and death. The individual’s adaptive response aims to increase energy provision to vital organs by increasing release of pituitary hormones, increasing sympathetic nervous system stimulation, and increasing peripheral resistance to anabolic hormones. Society of Critical Care Medicine (SCCM) and American Society of Parenteral and Enteral Nutrition (ASPEN)’s approach to nutritional is designed to preserve lean body mass, attenuate stress response, prevent oxidative injury, and modulate immune response.1 The current nutritional bundle includes (1) assess patients for nutritional risk and calculate energy and protein requirements to determine goals; (2) initiate enteral nutrition (EN) within 24 to 48 hours after the onset of critical illness and admission to the intensive care unit (ICU) and increase to goal within the first week of the ICU stay; (3) reduce the risk of aspiration or improve tolerance to gastric feeding with the use of prokinetic agents, continuous infusion, chlorhexidine mouthwash, elevation of the head of the bed, and diverted level of feeding in the gastrointestinal (GI) tract; (4) implement enteral feeding protocols with institution-specific strategies to promote delivery of enteral nutrition; (5) do not use gastric residual volumes as part of routine care to monitor ICU patients on EN; and (6) start parenteral nutrition (PN) early when EN is not feasible or sufficient in high-risk poorly nourished patients.1 SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1160188024 ER -