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Enteral nutrition in the ICU 

Enteral nutrition in the ICU
Chapter:
Enteral nutrition in the ICU
Author(s):

Shaul Lev

and Pierre Singer

DOI:
10.1093/med/9780199600830.003.0206
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date: 24 February 2020

Enteral nutrition (EN) is an integral part of the patient care in the intensive care unit (ICU) in order to maintain gut integrity, to modulate stress and the systemic immune response, and to attenuate disease severity. The timing of commencing EN in critically-ill patients depends on patient status and should be initiated as soon as the patient is stabilized. The energy and protein targets should be estimated and the feed prescription should match the nutritional target. The rate of EN dose increment or the addition of supplemental parenteral nutrition (PN) to reach the nutritional target is still debatable and ranges between 3 days (ESPEN approach) and up to 8 days (ASPEN approach). Micronutrients should be supplemented to all patients. The role of pharmaconutrition is controversial due to recent negative trials, but the use of EN with supplemental omega-3 and GLA for acute respiratory distress syndrome patients is still advocated by ESPEN and ASPEN guidelines.

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