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Crit Care. 2015 Jan 29;19:35. doi: 10.1186/s13054-015-0737-8.

Metabolic and nutritional support of critically ill patients: consensus and controversies.

Author information

1
Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, 808 route de Lennik, Brussels, 1070, Belgium. Jean-Charles.Preiser@erasme.ulb.ac.be.
2
Department of Intensive Care, Gelderse Vallei Hospital, Willy Brandtlaan 10, Ede, Gld 6716RP, The Netherlands. ZantenA@zgv.nl.
3
Service de Médecine Intensive Adulte et Brûlés, CHUV BH 08.612, Lausanne, CH 1011, Switzerland. mette.berger@chuv.ch.
4
Department of Medical, Surgical and Health Sciences, Clinica Medica AOUTS, University of Trieste, via Farneto 3, Trieste, 34142, Italy. Biolo@units.it.
5
Department and Laboratory of Intensive Care Medicine, University Hospitals Leuven (UZ Leuven), Herestraat 49, Leuven, B-3000, Belgium. michael.casaer@uz.kuleuven.ac.be.
6
Northern Clinical School Intensive Care Research Unit, University of Sydney, Reserve Road, St Leonards, NSW, 2065, Australia. gdoig@med.usyd.edu.au.
7
Department of Medicine, University of Liverpool, Liverpool, Merseyside, L69 3BX, UK. rdg@liverpool.ac.uk.
8
Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON, K7L 2 V7, Canada. dkh2@queensu.ca.
9
Division of Cardiac-Thoracic-Vascular Anesthesia and Intensive Care, Medical University Vienna, Spitalgasse 23, Wien, 1090, Austria. michael.hiesmayr@meduniwien.ac.at.
10
Department of Anesthesiology and Intensive Care, Universita' degli Studi di Milano, via Di Rudini' 8, Milano, 20142, Italy. g.iapichino@unimi.it.
11
Department of Clinical Medicine, Sapienza University, Piazzale Aldo Moro 5, Roma, 00185, Italy. alessandro.laviano@uniroma1.it.
12
Department of Nutrition, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, Geneva, 1211, Switzerland. claude.pichard@unige.ch.
13
Department of Intensive Care, Beilison Hospital, Petah Tikva, 49100, Israel. psinger@clalit.org.il.
14
Department and Laboratory of Intensive Care Medicine, University Hospitals Leuven (UZ Leuven), Herestraat 49, Leuven, B-3000, Belgium. greet.vandenberghe@med.kuleuven.be.
15
Department of Anesthesiology & Intensive Care Medicine, Karolinska University Hospital, Huddinge, Stockholm, 141 86, Sweden. jan.wernerman@karolinska.se.
16
Department of Anesthesiology, University of Colorado School of Medicine, 12700 E. 19th Ave, Box 8602, Aurora, CO, RC2 P15-7120, USA. Paul.Wischmeyer@ucdenver.edu.
17
Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, 808 route de Lennik, Brussels, 1070, Belgium. jlvincen@ulb.ac.be.

Abstract

The results of recent large-scale clinical trials have led us to review our understanding of the metabolic response to stress and the most appropriate means of managing nutrition in critically ill patients. This review presents an update in this field, identifying and discussing a number of areas for which consensus has been reached and others where controversy remains and presenting areas for future research. We discuss optimal calorie and protein intake, the incidence and management of re-feeding syndrome, the role of gastric residual volume monitoring, the place of supplemental parenteral nutrition when enteral feeding is deemed insufficient, the role of indirect calorimetry, and potential indications for several pharmaconutrients.

PMID:
25886997
PMCID:
PMC4310041
DOI:
10.1186/s13054-015-0737-8
[Indexed for MEDLINE]
Free PMC Article

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