Nutrition before, during and after critical illness

Ridley, Emma J.; Lambell, Kate

doi:10.1097/mcc.0000000000000961

Cited by 13 publications

(8 citation statements)

References 28 publications

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“…However, energy and protein intake should likely be further increased during convalescence when inflammation resolves and elevated muscle protein breakdown rates decrease, particularly when combined with physical activity [43]. Several studies have shown poor feeding performance among post-ICU patients (50–70% of energy and protein adequacy) [1,44 ▪ ], highlighting the need for specific interventions. Inadequate intake in the post-ICU phase is multifactorial [44 ▪ ,45].…”

Section: Post-icu Nutritionmentioning

confidence: 99%

“…Critical care nutrition is a rapidly evolving field in which significant steps have been made toward nutritional recommendations specific to each patient. This shift allows healthcare providers to consider the patient's characteristics, medical diagnosis, current treatments, and metabolic state [1]. The multifactorial nature of nutritional needs in critically ill patients and the difference in outcomes and methodologies assessed in available studies pose challenges to establishing fitting guidelines.…”

Section: Introductionmentioning

confidence: 99%

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Current insights in ICU nutrition: tailored nutrition

Hermans

Laarhuis²,

Kouw

et al. 2023

Current Opinion in Critical Care

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Purpose of reviewTo summarize recent research on critical care nutrition focusing on the optimal composition, timing, and monitoring of enteral feeding strategies for (post)-ICU patients. We provide new insights on energy and protein recommendations, feeding intolerance, and describe nutritional practices for coronavirus disease 2019 ICU patients.Recent findingsThe use of indirect calorimetry to establish individual energy requirements for ICU patients is considered the gold standard. The limited research on optimal feeding targets in the early phase of critical illness suggests avoiding overfeeding. Protein provision based upon the absolute lean body mass is rational. Therefore, body composition measurements should be considered. Body impedance analysis and muscle ultrasound seem reliable, affordable, and accessible methods to assess body composition at the bedside. There is inadequate evidence to change our practice of continuous enteral feeding into intermittent feeding. Finally, severe acute respiratory syndrome coronavirus 2 patients are prone to underfeeding due to hypermetabolism and should be closely monitored.SummaryNutritional therapy should be adapted to the patient's characteristics, diagnosis, and state of metabolism during ICU stay and convalescence. A personalized nutrition plan may prevent harmful over- or underfeeding and attenuate muscle loss. Despite novel insights, more research is warranted into tailored nutrition strategies during critical illness and convalescence.

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Section: Post-icu Nutritionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Current insights in ICU nutrition: tailored nutrition

Hermans

Laarhuis²,

Kouw

et al. 2023

Current Opinion in Critical Care

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show abstract

“…As feeding is already initiated for most patients in the ICU, it is important to reassess their special nutritional needs following transfer to the medical ward. This process requires the multidisciplinary cooperation of all involved personal to ensure optimal continued care [2].…”

Section: Feeding Strategy and Nutritional Support In The Recovery Pha...mentioning

confidence: 99%

“…Implementation of guidelines in clinical practice remains challenging. Nutritional feeding protocols must be continued and adapted once patients survive the acute phase of illness and transition to the medical ward for recovering phase [2]. Subsequently, patients may transition to a rehabilitation phase, which can also last for months [3].…”

Section: Introductionmentioning

confidence: 99%

Nutritional issues concerning general medical ward patients: feeding patients recovering from critical illness

Gressies

Schüetz

2022

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of reviewICU survivors often spend long periods of time in general wards following transfer from ICU in which they are still nutritionally compromised. This brief review will focus on the feeding of patients recovering from critical illness, as no formal recommendations or guidelines on nutrition management are available for this specific situation.Recent findingsWhile feeding should start in the ICU, it is important to continue and adapt nutritional plans on the ward to support individuals recovering from critical illness. This process is highly complex – suboptimal feeding may contribute significantly to higher morbidity and mortality, and seriously hinder recovery from illness. Recently, consensus diagnostic criteria for malnutrition have been defined and large-scale trials have advanced our understanding of the pathophysiological pathways underlying malnutrition. They have also helped further develop treatment algorithms. However, we must continue to identify specific clinical parameters and blood biomarkers to further personalize therapy for malnourished patients. Better understanding of such factors may help us adapt nutritional plans more efficiently.SummaryAdequate nutrition is a vigorous component of treatment in the post-ICU period and can enhance recovery and improve clinical outcome. To better personalize nutritional treatment because not every patient benefits from support in the same manner, it is important to further investigate biomarkers with a possible prognostic value.

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“…It is critical to look into how diet affects clinical and functional outcomes across hospitalization and to use interventions in ways that are biologically likely to have an impact. Individualized nutrition plans, longer-lasting therapies, oral nutrition assistance, and the use of newly developed bedside body composition tools to detect patients at nutritional risk are all areas that hold promise for the future of critical care nutrition (18).…”

Section: Prevention and Management Of Malnutritionmentioning

confidence: 99%

Identification, Prevention and Management of Malnutrition in the Critically Ill Patients

Aboshoushah¹,

Albarakati²,

Almajayishi³

et al. 2022

JOHS

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Proper nutrition is essential for enhancing healthcare outcomes. Elevated rates of malnutrition are present in hospitalized patients. Malnutrition and unmet nutritional needs increase morbidity and mortality, lower quality of life, lengthen the time spent on mechanical ventilation, and lengthen hospital stays, all of which raise the expense of medical treatment. Patients who are critically ill need specific care to minimize muscle wasting, avoid overfeeding, and prevent complications from nutritional therapy. The purpose of this research is to review the available information about identification, prevention, and management of malnutrition in the critically ill patients. To identify patients who are more likely to experience complications from malnutrition, nutritional status is evaluated. Various assessment methods and tools are present to identify malnutrition in critically ill patients. Effective targeting of appropriate nutrient levels, and prompt initiation of nutritional support, among other measures can reduce the risk of malnutrition. Ideally, enteral nutrition should be started after initial 24 to 48 hours. Parenteral nutrition may be employed if the nutritional need is not properly supplied by enteral nutrition even after seven days following intensive care admission. In patients receiving nutrition therapy, electrolytes should be carefully assessed. Even if 50% to 60% of nutritional requirements are not successfully met during 72 hours of oral nutrition support then tube feeding should be considered. Further clinical research can be beneficial in determining the effectiveness and outcomes of nutritional therapy in malnourished critically ill patients.

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Nutrition before, during and after critical illness

Cited by 13 publications

References 28 publications

Current insights in ICU nutrition: tailored nutrition

Current insights in ICU nutrition: tailored nutrition

Nutritional issues concerning general medical ward patients: feeding patients recovering from critical illness

Identification, Prevention and Management of Malnutrition in the Critically Ill Patients

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