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Pathophysiology of nutritional failure in the critically ill 

Pathophysiology of nutritional failure in the critically ill
Chapter:
Pathophysiology of nutritional failure in the critically ill
Author(s):

Jan Wernerman

DOI:
10.1093/med/9780199600830.003.0203
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date: 01 December 2020

Nutritional and metabolic care makes a difference in critical illness. Optimal nutrition can improve outcomes and complications with nutrition may do harm. The energy needs of critically-ill patients are controversial, and it is important to discriminate between this initial phase of critical illness and a more stable phase evolving into rehabilitation. Indirect calorimetry is very helpful to optimize the energy supply. It is repeatedly suggested that protein supply to critically-ill patients should be higher than to healthy individuals. There is, however, little evidence for this proposal, although it is a part of most guidelines. To consider nutritional failure, optimal nutrition should be defined. In critical illness more mechanistic research is needed to define optimal nutrition and metabolic care.

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