NNIW08 - Nutrition and Critical Nutrition

Editor(s): L. Cynober, F.A. Moore. Clinical Nutrition vol. 08


Nutrition and Critical Care

Author(s): W. Endres

Severe metabolic alterations frequently occur in critically ill patients. Ifnutrition plays an important role in critical care, what are the needs forcritically ill patients?

Overview on Metabolic Adaptation to Stress

Author(s): V.E. Baracos

The patients that we wish to feed properly are stressed in different waysand very often in more than one way. The word ‘stress’ appears in thenutrition and clinical nutrition literature attached to a wide variety ofmeanings.

Genetic Polymorphisms, Functional Genomics and the Host Inflammatory Response to Injury and Inflammation

Author(s): R.J. Feezor, L.L. Moldawer

The term ‘sepsis’ refers to the host’s systemic inflammatory response toan invasive microbial challenge; when the clinical constellation includeshypotension and/or concurrent end-organ injury, the condition is known as‘severe sepsis’ or ‘septic shock’.

Modulation of the Post-Burn Hypermetabolic State

Author(s): J.O. Lee, D.N. Herndon

Burn patients have the highest metabolic rate of all critically ill or injuredpatients. The metabolic response to a severe burn injury is characterizedby a hyperdynamic cardiovascular response, increased energy expenditure,accelerated glycogen and protein breakdown, lipolysis, loss of lean body massand body weight, delayed wound healing, and immune depression [1, 2].

Nutrition Support in Critical Illness: Amino Acids

Author(s): P. Stehle

The general approach to the nutritional care of the catabolic, malnourishedor critically ill patient involves delivery of a balanced diet including energy(in the form of carbohydrates and lipids), an adequate amount of nitrogen,all essential nutrients (amino acids, fatty acids, vitamins, electrolytes) andfluid [1].

Lipids and the Critically Ill Patient

Author(s): P.C. Calder

Lipid metabolism is altered in the critically ill patient as a result of changesin the status of hormones and other mediators [for reviews see, 1–3]. Enhancedmobilization of adipose tissue triacylglycerol stores is characteristic of themetabolic response to severe stress.

Key Vitamins and Trace Elements in the Critically Ill

Author(s): M.M. Berger, R.L. Chioléro

Trace elements and vitamins are essential components of nutrition (unlessspecified, vitamins and trace elements will hereafter be designated globally asmicronutrients).

What Is the Goal of Nutrition in the Intensive Care Unit?

Author(s): S.P. Allison

It is difficult to give a simple answer to this question for a number ofreasons. Firstly, because the major determinants of outcome on the ICU arethe severity of the disease, coincident cardiorespiratory pathology, sepsis andorgan failure.

Enteral Versus Parenteral Nutrition: Alterations in Mechanisms of Function in Mucosal Host Defenses

Author(s): Ni.A. Meyer, K.A. Kudsk

Parenteral nutrition has significantly advanced the survival of patients whosustain major loss to the GI tract or prolonged delayed ability to take oral ortube feedings.

Gut Dysfunction and Intolerance to Enteral Nutrition in Critically Ill Patients

Author(s): F.A. Moore, N.W. Weisbrodt

For patients who survive the first 48 h of intensive care, sepsis-relatedmultiple organ failure (MOF) is the leading cause for prolonged intensive careunit (ICU) stays and deaths.

Nutrition of Premature and Critically Ill Neonates

Author(s): J. Neu, Y. Huang

Advances in mechanical ventilation, the use of pulmonary surfactants,improved pharmacological management of expectant mothers and preterminfants and greater confidence in our overall intensive care techniques haveresulted in a marked increase in the number of very immature infants whosurvive.

Nutritional Support of Obese Critically Ill Patients

Author(s): R.L. Chioléro, L. Tappy, M.M. Berger

Obesity is a common medical condition affecting more than 1 in 10 adultsin Western European countries [1]. Its prevalence varies considerably indifferent countries. In Europe, it amounts to about 10–15% of the middleagedpopulation.

Nutritional Support in Acute Pancreatitis

Author(s): S.A. McClave

That pancreatic rest and a reduction in exocrine secretion may allow amore expedient resolution of pancreatic inflammation is an important clinicalprecept in the management of patients with acute pancreatitis.

Nutritional Support in Sepsis and Multiple Organ Failure

Author(s): G. Nitenberg

The scope of this review is to provide practical guidelines for nutritionalmanagement of critically ill patients with sepsis with or without multipleorgan failure (MOF).

Nutraceuticals in Critical Care Nutrition

Author(s): H. Schmidt, R. Martindale

The importance of nutritional support in surgical patients cannot beoverstated, particularly in the realm of intensive care settings. Prevention ofmucosal atrophy and stimulation of the gut-associated lymphoid tissue(GALT) by early enteral feeding in postoperative surgical patients has onlyrecently become part of our standard of care.

Lessons from Pharmacokinetics in the Design of New Nutrition Formulas for Critically Ill Patients

Author(s): L. Cynober

Severe injury causes alterations in protein metabolism [1], including netmuscle protein breakdown, increased transfer of amino acids (AAs) from theperipheral to the splanchnic area, intense use of AAs for gluconeogenesis andconsequently a marked increase in nitrogen loss, leading to a negativenitrogen balance [2].

Nutritional Support in Icu Patients: Position of Scientific Societies

Author(s): F. Bozzetti, B. Allaria

The most prominent metabolic alterations which characterize the systemicinflammatory response syndrome and sepsis include hypermetabolism,hyperglycemia with insulin resistance, accelerated lipolysis and net proteincatabolism [1–3].