Nutrition

Abstract

In this chapter aspects on nutritional requirements in the ICU patient are reviewed. The aim of nutritional support is to preserve tissue mass and decrease usage of endogenous nutrient stores, decrease catabolism, decrease infection, and maintain/improve organ function (immune, renal, hepatic, muscle). Timing of nutritional support remains controversial. Accumulating data suggest that outcome can be improved with early and optimal nutritional support. Routes of nutritional support include parenteral nutrition delivery via peripheral or central vein, enteral nutrition delivered orally, gastric tube, and small bowel feeding tube. Oral nutrition remains the best form of nutritional support, but in critical patients, it is not possible. Most critically ill patients need 1.2–2.0 g/kg/day. Nutrition for specific disease processes like acute renal failure, hepatic failure, inflammatory bowel disease/pancreatitis, and multiple organ failure are explained in this chapter. Approach to enteral feeding and enteral nutritional support should be initiated within 12–48 h of admission to the ICU. Useful facts and formulas, nutritional assessment, total daily energy, nitrogen balance, and fuel composition.