Nutrition Literature Summaries
summaries of key studies from the intensive care nutrition literature
Category nutrition
Nutritional Assessment in the Critically Ill
Nutritional Assessment in Critical Illness: poor nutritional state is a common feature of critically ill patients, either pre-existing or as a result of the illness
Overfeeding
In the 1980s, the concept of parenteral hyperalimentation or hypercaloric feeding was dominant. This was stopped due to the sequelae, which limit attempts to rapidly correct malnutrition. Some early studies suggesting harm from early feeding were actually showing the effects of overfeeding
Periprocedural Fasting
Periprocedural fasting is widely performed with little evidence base. NBM = nil by mouth; NPO = nil per oral
Prokinetics
Prokinetics are agents that increase gastrointestinal motility. Gastroparesis common -> increased gastric residual volumes -> GORD, aspiration risk and inability to meet nutrition targets. Theoretically, an increase in gastric motility helps in establishing target enteral feeds early in critically ill patients, which improves outcome
Refeeding Syndrome
Refeeding Syndrome = a group of clinical findings that occur in severely malnourished individuals undergoing nutritional support.
Substrate Metabolism – Rest versus Stress
Rest = basal metabolic rate + minimal exercise. Major stress = 50% burn. The body's goal is to preserve plasma glucose levels for brain metabolism.
Total Parenteral Nutrition (TPN)
Total parental nutrition (TPN) is the complete provision of nutrition intravenously, bypassing the GI tract.
Vitamin D in Critical illness
OVERVIEW Vitamin D is a fat soluble vitamin with dermal synthesis being the major natural source Main clinically significant role is in maintaining calcium homeostasis and bone metabolism There is an increasing appreciation for its pleiotropic effects, including immunomodulatory and…