Category: Intensive care

Studies indicate that for many critically ill patients, providing fewer calories than traditionally recommended may lead to better health outcomes. Permissive underfeeding is a medical approach that intentionally delivers reduced caloric intake during the initial phases of critical illness to help manage the body's metabolic response.

Intravenous food, medically known as parenteral nutrition, delivers essential nutrients directly into a patient's bloodstream. This critical intervention is reserved for patients in the Intensive Care Unit (ICU) who cannot receive or absorb enough food through their digestive tract to meet their nutritional needs. The customized IV solution is formulated to sustain the patient during severe illness or after major surgery.

Critical illness significantly increases a patient's protein requirements due to a heightened state of catabolism and metabolic stress. This elevated demand contrasts sharply with the needs of healthy individuals.

According to a 2021 review in the Journal of Intensive Care, indirect calorimetry is considered the gold standard method for determining energy requirements in critically ill patients. This advanced technique measures a patient's oxygen consumption and carbon dioxide production to provide a precise, real-time assessment of their metabolic rate.

International guidelines for critically ill patient nutrition have widely recommended high protein intake (1.2–2.0 g/kg/day), but robust evidence to support this approach has been surprisingly limited. The question of whether a higher or lower protein delivery is optimal in critically ill patients is complex and depends heavily on timing, patient-specific factors, and comorbidities like acute kidney injury (AKI).

Propofol is formulated as a lipid emulsion, not in a way that allows for a simple conversion of kcal per mg. A 1% propofol solution, which contains 10 mg of propofol per milliliter, delivers 1.1 kcals per milliliter of the emulsion.

Albumin is the most abundant protein in human blood plasma, produced by the liver, and accounts for up to 80% of the blood's oncotic pressure. This critical protein is frequently administered intravenously in hospital settings to manage a variety of severe medical conditions where the body's natural levels have fallen dangerously low.

Malnutrition is a significant concern for critically ill patients, with prevalence rates ranging from 38% to 78% depending on the population studied. In response to the need for a reliable and specific assessment tool, researchers developed the Nutritional Risk in the Critically Ill (NUTRIC) score to help identify patients most likely to benefit from aggressive nutrition support.

Trophic feeding, giving small volumes of milk to immature infants, has been shown to improve gut development. However, this is fundamentally different from a full feed, which provides all the necessary calories and nutrients for a patient. Understanding the distinction between trophic and full feeds is crucial in various clinical settings, from neonatal care to the critical care unit.

Malnutrition is a significant concern, with its prevalence in critically ill patients ranging between 38% and 78%. A deteriorating nutritional status can negatively impact recovery and increase morbidity and mortality in these vulnerable patients. Understanding what is the nutritional status of critically ill patients is therefore a cornerstone of effective intensive care.