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Practical Aspects of Nutrition

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Abstract

The aim of this chapter is to summarize enteral (EN) and parenteral (PN) nutrition techniques, indications and contraindications, existing formulae and usual complications and their prevention. Early feeding is briefly discussed and the timing for starting nutritional support EN or PN is explained. It states the importance of creating local nutrition ICU protocols, in order to allow the integration of local treatment possibilities and formulae, and describing the respective tasks and responsibilities of each nutritional care team member, such as nurses, dieticians and doctors. The value of including a thorough nutritional monitoring in the protocols is also discussed, as a cornerstone of nutritional support complications’ prevention, early detection and management.

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References

  1. Simpson F, Doig GS. Parenteral vs. enteral nutrition in the critically ill patient: a meta-analysis of trials using the intention to treat principle. Intensive Care Med. 2005;31:12–23.

    Article  PubMed  Google Scholar 

  2. Seron-Arbeloa C, Zamora-Elson M, Labarta-Monzon L, Mallor-Bonet T. Enteral nutrition in critical care. J Clin Med Res. 2013;5:1–11.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Gatt M, Reddy BS, MacFie J. Review article: bacterial translocation in the critically ill—evidence and methods of prevention. Aliment Pharmacol Ther. 2007;25:741–57.

    Article  CAS  PubMed  Google Scholar 

  4. Reintam Blaser A, Starkopf J, Alhazzani W, Berger MM, Casaer MP, Deane AM, Fruhwald S, Hiesmayr M, Ichai C, Jakob SM, Loudet CI, Malbrain ML, Montejo Gonzalez JC, Paugam-Burtz C, Poeze M, Preiser JC, Singer P, van Zanten AR, De Waele J, Wendon J, Wernerman J, Whitehouse T, Wilmer A, Oudemans-van Straaten HM, Function ESICM Working Group on Gastrointestinal. Early enteral nutrition in critically ill patients: ESICM clinical practice guidelines. Intensive Care Med. 2017;43:380–98.

    Google Scholar 

  5. Davies AR, Morrison SS, Bailey MJ, Bellomo R, Cooper DJ, Doig GS, Finfer SR, Heyland DK, Investigators Enteric Study, Anzics Clinical Trials Group. A multicenter, randomized controlled trial comparing early nasojejunal with nasogastric nutrition in critical illness. Crit Care Med. 2012;40:2342–8.

    Article  PubMed  Google Scholar 

  6. Zadak ZM, Nyulasi I, Lochs H, Kent-Smith L, Pirlich M.Commercially prepared diets for enteral nutrition. In: Sobotka L, editor. Basics in clinical nutrition. 2011. 4th ed. pp. 333–43. Prague: Galén.

    Google Scholar 

  7. Charrière M, Ridley E, Hastings J, Bianchet O, Scheinkestel C, Berger MM. Propofol sedation substantially increases the caloric and lipid intake in critically ill patients. Nutrition. 2017;42:64–8.

    Google Scholar 

  8. Berger MM, Revelly JP, Wasserfallen JB, Schmid A, Bouvry S, Cayeux MC, Musset M, Maravic P, Chiolero RL. Impact of a computerized information system on quality of nutritional support in the ICU. Nutrition. 2006;22:221–9.

    Article  PubMed  Google Scholar 

  9. Heidegger CP, Berger MM, Graf S, Zingg W, Darmon P, Costanza MC, Thibault R, Pichard C. Optimisation of energy provision with supplemental parenteral nutrition in critically ill patients: a randomised controlled clinical trial. Lancet. 2013;381:385–93.

    Article  PubMed  Google Scholar 

  10. Bittencourt AF, Martins JR, Logullo L, Shiroma G, Horie L, Ortolani MC, Silva Mde L, Waitzberg DL. Constipation is more frequent than diarrhea in patients fed exclusively by enteral nutrition: results of an observational study. Nutr Clin Pract. 2012;27:533–9.

    Article  PubMed  Google Scholar 

  11. Thibault R, Graf S, Clerc A, Delieuvin N, Heidegger CP, Pichard C. Diarrhoea in the intensive care unit: respective contribution of feeding and antibiotics. Crit Care. 2013;17:R153.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Harvey SE, Parrott F, Harrison DA, Bear DE, Segaran E, Beale R, Bellingan G, Leonard R, Mythen MG, Rowan KM, Investigators Calories Trial. Trial of the route of early nutritional support in critically ill adults—Calories Trial. N Engl J Med. 2014;371:1673–84.

    Article  PubMed  Google Scholar 

  13. Doig GS, Simpson F, Sweetman EA, Finfer SR, Cooper DJ, Heighes PT, Davies AR, O’Leary M, Solano T, Peake S, Early PN, Investigators of the Anzics Clinical Trials Group. Early parenteral nutrition in critically ill patients with short-term relative contraindications to early enteral nutrition: a randomized controlled trial. JAMA. 2013;309:2130–8.

    Article  CAS  PubMed  Google Scholar 

  14. Berger MM. The 2013 arvid wretlind lecture: evolving concepts in parenteral nutrition. Clin Nutr. 2014;33:563–70.

    Article  PubMed  Google Scholar 

  15. Stehle P, Ellger B, Kojic D, Feuersenger A, Schneid C, Stover J, Scheiner D, Westphal M. Glutamine dipeptide-supplemented parenteral nutrition improves the clinical outcomes of critically ill patients: a systematic evaluation of randomised controlled trials. Clin Nutr ESPEN. 2017;17:75–85.

    Article  PubMed  Google Scholar 

  16. Calder PC. Lipids for intravenous nutrition in hospitalised adult patients: a multiple choice of options. Proc Nutr Soc. 2013;72:263–76.

    Article  CAS  PubMed  Google Scholar 

  17. Singer P, Berger MM, Van den Berghe G, Biolo G, Calder P, Forbes A, Griffiths R, Kreyman G, Leverve X, Pichard C. ESPEN guidelines on parenteral nutrition: intensive care. Clin Nutr. 2009;28:387–400.

    Article  PubMed  Google Scholar 

  18. Doig GS, Simpson F, Heighes PT, Bellomo R, Chesher D, Caterson ID, Reade MC, Harrigan PW, Refeeding Syndrome Trial Investigators Group. Restricted versus continued standard caloric intake during the management of refeeding syndrome in critically ill adults: a randomised, parallel-group, multicentre, single-blind controlled trial. Lancet Respir Med. 2015;3:943–52.

    Article  PubMed  Google Scholar 

  19. Singer P, Reintam Blaser A, Berger MM, Calder P, Casear M, Hiesmayr M, Mayer K, Montejo JC, Pichard C, Preiser JC, Tepinski P, van Zanten AR. ESPEN guidelines for the critically ill patient. Clinical Nutr. 2018.

    Google Scholar 

  20. McClave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C, McCarthy MS, Davanos E, Rice TW, Cresci GA, Gervasio JM, Sacks GS, Roberts PR, Compher C, Society of Critical Care Medicine, American Society for Parenteral, Enteral Nutrition. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2016;40:159–211.

    Article  CAS  PubMed  Google Scholar 

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Charrière, M., Berger, M.M. (2018). Practical Aspects of Nutrition. In: Berger, M. (eds) Critical Care Nutrition Therapy for Non-nutritionists. Springer, Cham. https://doi.org/10.1007/978-3-319-58652-6_13

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  • DOI: https://doi.org/10.1007/978-3-319-58652-6_13

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-58652-6

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