Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient:

McClave, Stephen A.; Martindale, Robert G.; Vanek, Vincent W.; McCarthy, Mary S.; Roberts, Pamela R.; Taylor, Beth; Ochoa, Juan B.; Napolitano, Lena M.; Cresci, Gail

doi:10.1177/0148607109335234

Cited by 1,576 publications

(936 citation statements)

References 288 publications

(368 reference statements)

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“…(9) These recommendations stand in contradiction to many previously published prospective and cohort studies in nutrition and critical care. The Society of Critical Care Medicine, the American Society of Parenteral and Enteral Nutrition, (10) and the Canadian (11) and European (12) nutrition guidelines recommend early initiation of EN (within 48 hours of ICU admission) in patients who are unable to achieve goal oral intake.…”

Section: Introductionmentioning

confidence: 99%

Effects of enteral nutrition on clinical outcomes among mechanically ventilated and sedated patients in the pediatric intensive care unit

Tripathi

Kaur²,

Varayil³

et al. 2015

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Section: Introductionmentioning

confidence: 99%

Effects of enteral nutrition on clinical outcomes among mechanically ventilated and sedated patients in the pediatric intensive care unit

Tripathi

Kaur²,

Varayil³

et al. 2015

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“…Hoy día, estas metas se han focalizado más en atenuar la respuesta metabólica al estrés, prevenir la lesión celular oxidativa y modular la respuesta inmune. La modulación de la respuesta al estrés se logra con nutrición enteral temprana, aporte adecuado de macro y micronutrientes y un estricto control glucémico; dichas estrategias pueden reducir la intensidad de la enfermedad, las complicaciones y la estancia en UCI, impactando favorablemente la respuesta del paciente (54). La imposibilidad de utilizar el intestino en los pacientes críticos puede afectar la inmunidad adquirida y el balance del perfil de linfocitos Th1:Th2.…”

Section: Modulación De La Microbiota Intestinal En Pacientes Críticosunclassified

Microbiota intestinal y ácidos grasos de cadena corta en pacientes críticos

Ochoa

Giraldo

Barrera-Causil

et al. 2017

Perspect Nutr Humana

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ResumenAntecedentes: diversos estudios han mostrado cambios en la microbiota intestinal (MI) y los áci-dos grasos de cadena corta (AGCC) en pacientes críticos con síndrome de respuesta inflamatoria sistémica (SRIS). Objetivo: revisar la evidencia sobre el papel de la MI y los AGCC en pacientes críticos y su modulación con prebióticos, probióticos y simbióticos. Materiales y métodos: búsque-da de artículos en bases de datos bibliográficas Pubmed, Science Direct, Ovid, Medline y Scopus, utilizando como descriptores microbiota, paciente crítico, unidad de cuidados intensivos, síndrome de respuesta inflamatoria sistémica, ácidos grasos de cadena corta, probióticos, prebióticos y simbióticos. Resultados: la MI en pacientes críticos está disminuida tanto en número de bacterias como en diversidad, lo cual puede resultar en una desregulación de la respuesta inmune sistémica ante la invasión de microorganismos patógenos. Los cambios en los AGCC en pacientes críticos se atribuyen a una disminución de bacterias anaerobias obligadas y sustratos de fermentación necesarios para su producción. La modulación de la MI con probióticos, prebióticos y simbióticos sugiere mejoría en la función intestinal. Conclusiones: la MI y los AGCC en pacientes críticos se encuentran alterados, de ahí que mantener el equilibrio en el entorno intestinal probablemente desempeñe una función clave para disminuir complicaciones y mejorar su pronóstico.Palabras clave: paciente crítico, microbiota, ácidos grasos de cadena corta, síndrome de respuesta inflamatoria sistémica, probióticos, prebióticos, simbióticos. Gut Microbiota and Short-Chain Fatty Acids in Critically Ill Patients AbstractBackground: Different studies have shown changes in gut microbiota and short-chain fatty acids in critically ill patients with Systemic Inflammatory Response Syndrome (SIRS). Aim: To review the evidence about the role of gut microbiota and SCFAs in critically patients and its modulation with prebiotics, probiotics and symbiotic. Materials and Methods: A search of the literature in Pubmed, Science Direct, Ovid, Medline and Scopus databases was conducted. The terms used were microbiota, critically ill, intensive care unit, systemic inflammatory response syndrome, short-chain fatty acids, prebiotics, probiotics and symbiotic. Results: The intestinal microbiota in critically ill patients is reduced in number and diversity, which can lead to dysregulation of the systemic immune response to the pathogenic invasion. Changes in SCFAs in critically ill patients are attributed to a decrease of obligate anaerobic bacteria and the fermentation substrates required for its production. The gut microbiota modulation with prebiotics, probiotics and symbiotic suggest improvement in bowel function. Conclusions: Gut microbiota and SCFAs are altered in critically ill patients; therefore, maintaining the intestinal environment is key for reducing complications and improving prognosis.

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“…86 There is a consensus on the recommendation of obtaining the actual EE using IC, if possible, in individuals kept under intensive care, more specifically, people with AKI. 31,87 The negative impact of overfeeding and underfeeding in the prognosis of these patients and within this context is well-known. Determining the REE and the adequate supply of nutrients is paramount as it contributes to preserve lean body mass and energy reserves, to restore the immune function, to attenuate the inflammatory response and oxidative stress, and to reduce mortality rates in patients with AKI.…”

Section: Energy Expenditure In Acute Kidney Injurymentioning

confidence: 99%

“…30 US guidelines recommend 25 to 30 kcal/kg of current body weight in adults, and in the case of critically-ill obese patients, they recommend 11 to 14 kcal/kg of current body weight or 22 to 25 kcal/kg of ideal body weight (IW). 31 DC is a method based on the use of a thermally insulated chamber to directly measure the heat generated by the body. It is considered highly precise (1 to 2% error), but with little viable applicability 32 as it requires a very sophisticated camera and permanence of the subject in the chamber for a period equal to or greater than 24 hours.…”

mentioning

confidence: 99%

Resting energy expenditure in critically ill patients: Evaluation methods and clinical applications

Sanches

Góes

Bufarah

et al. 2016

Rev. Assoc. Med. Bras.

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SancheS acS et al. 672rev assoC med bras 2016; 62(7):672-679 Patients on intensive care present systemic, metabolic, and hormonal alterations that may adversely affect their nutritional condition and lead to fast and important depletion of lean mass and malnutrition. Several factors and medical conditions can influence the energy expenditure (EE) of critically ill patients, such as age, gender, surgery, serious infections, medications, ventilation modality, and organ dysfunction. Clinical conditions that can present with EE change include acute kidney injury, a complex disorder commonly seen in critically ill patients with manifestations that can range from minimum elevations in serum creatinine to renal failure requiring dialysis. The nutritional needs of this population are therefore complex, and determining the resting energy expenditure is essential to adjust the nutritional supply and to plan a proper diet, ensuring that energy requirements are met and avoiding complications associated with overfeeding and underfeeding. Several evaluation methods of EE in this population have been described, but all of them have limitations. Such methods include direct calorimetry, doubly labeled water, indirect calorimetry (IC), various predictive equations, and, more recently, the rule of thumb (kcal/kg of body weight). Currently, IC is considered the gold standard.Keywords: energy expenditure, critically ill patient, energy requirement, indirect calorimetry.iMportance of deterMining energy expenditure in critically ill patients Adequate supply of nutrients is an essential part of the overall treatment of critically ill patients and adjustment of nutritional requirements to the individual needs of patients is a matter crucial to their clinical evolution, because both situations, overfeeding and underfeeding, may contribute to high morbidity and mortality in this population. 1,2 In such a context, an adequate assessment of energy expenditure (EE) is the basis of effective nutritional planning. 3 Total energy expenditure (TEE) is defined as the energy required by the body daily, determined by adding the following components: basal energy expenditure (BEE), diet--induced thermogenesis (DIT) and physical activity (PA). 4 BEE reflects the energy requirements to maintain the intracellular environment and mechanical processes such as respiration and cardiac function, as well as thermoregulatory mechanisms responsible for regulating the body temperature. 5,6 It is considered the main component in TEE, contributing 60 to 75% of the daily energy requirement for most sedentary individuals and approximately 50% for the physically active. BEE must be measured in thermoneutral conditions (20ºC) in the absence of recent nutrient administration (12 to 14 hours of fasting), recent physical activity (at least 8 hours of sleep), and psychological stress, while the subject is fully awake, lying in silence, completely relaxed and breathing normally.The energy corresponding to the thermal effect of food refers to the expenditure caused by dige...

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Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient:

Cited by 1,576 publications

References 288 publications

Effects of enteral nutrition on clinical outcomes among mechanically ventilated and sedated patients in the pediatric intensive care unit

Effects of enteral nutrition on clinical outcomes among mechanically ventilated and sedated patients in the pediatric intensive care unit

Microbiota intestinal y ácidos grasos de cadena corta en pacientes críticos

Resting energy expenditure in critically ill patients: Evaluation methods and clinical applications

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