RT Book, Section
A1 Al-Dorzi, Hasan M.
A1 Arabi, Yaseen M.
A2 Schmidt, Gregory A.
A2 Kress, John P.
A2 Douglas, Ivor S.
SR Print(0)
ID 1201799587
T1 Nutrition for Critically Ill Patients
T2 Hall, Schmidt and Wood’s Principles of Critical Care, 5<sup>th</sup> Edition
YR 2023
FD 2023
PB McGraw Hill
PP New York, NY
SN 9781264264353
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1201799587
RD 2024/10/13
AB The  timing,  dose,  composition,  and  route  of  nutritional  support  influence  the  outcomes  of  critically  ill  patients.The  gastrointestinal  tract  plays  a  pivotal  role  in  the  pathogenesis  of  acute  critical  illness  and  may  affect  its  outcomes.Enteral  nutrition  is  preferred  to  parenteral  nutrition  in  critically  ill  patients  in  the  absence  of  severe  shock  and  gastrointestinal  contraindications.Early  enteral  nutrition  (within  24-48  hours)  using  a  feeding  protocol  with  gradual  increase  of  the  dose  to  reach  the  calorie  target  within  5-7  days  is  the  preferred  feeding  strategy  for  most  critically  ill  patients.Parenteral  nutrition  is  indicated  if  enteral  nutrition  is  not  feasible  or  does  not  meet  calorie  targets  by  the  end  of  the  first  week  of  critical  illness.Protein  intake  is  an  important  element  of  nutritional  support  with  the  current  evidence  favoring  higher  doses  after  the  acute  phase  of  critical  illness.Immunonutrition  should  not  be  used  routinely.  Supplementation  of  glutamine  is  indicated  in  certain  patients  (burn  and  trauma  cases).Enteral  feeding  intolerance  commonly  complicates  enteral  nutrition.  However,  the  routine  monitoring  of  gastric  residual  volume  does  not  prevent  aspiration  pneumonia  and  does  not  affect  outcome.