Controversies in Critical Care Nutrition Support

Jayshil J Patel; Panna Codner

doi:10.1016/j.ccc.2015.11.002

Controversies in Critical Care Nutrition Support

Crit Care Clin. 2016 Apr;32(2):173-89. doi: 10.1016/j.ccc.2015.11.002. Epub 2016 Feb 4.

Authors

Jayshil J Patel¹, Panna Codner²

Affiliations

¹ Division of Pulmonary & Critical Care Medicine, Department of Medicine, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA. Electronic address: jpatel2@mcw.edu.
² Division of Trauma and Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.

PMID: 27016160
DOI: 10.1016/j.ccc.2015.11.002

Abstract

Critical illness predisposes individuals to highly variable metabolic and immune responses, leading to muscle mass loss, impaired healing, immobility, and susceptibility to infections and cognitive impairment. Recommendations for nutrition in critically ill patients are supported by observational studies, small randomized controlled trials, and mechanistic data. There is no standardization of nutritional therapy in critically ill patients and controversies in the type, quantity, and timing of nutrition support persist. This article reviews the physiologic basis for nutrition support, the concept of nutritional risk, and various controversies in critical care nutrition support.

Keywords: Autophagy; Enteral nutrition; Nutritional risk; Parenteral nutrition; Permissive underfeeding; Shock; Trophic feeding.

Publication types

Review

MeSH terms

Critical Care / methods*
Critical Care / standards*
Critical Illness / therapy*
Enteral Nutrition / methods*
Enteral Nutrition / standards*
Humans
Nutritional Support / methods*
Nutritional Support / standards*