How many calories are necessary during critical illness?

Several nutritional alternatives exist to provide critically ill patients sufficient calories to meet metabolic demands. Intuitively, investigators, nutritionists, and clinicians have pursued the goal of providing high-calorie nutrition support, believing that this would improve outcomes. There is l...

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Bibliographic Details
Published inGastrointestinal endoscopy clinics of North America Vol. 17; no. 4; p. 703
Main Authors Caba, David, Ochoa, Juan B
Format Journal Article
LanguageEnglish
Published United States 01.10.2007
Subjects
Critical Illness
Energy Intake
Humans
Nutritional Status
Nutritional Support
Parenteral Nutrition
Starvation
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Summary:Several nutritional alternatives exist to provide critically ill patients sufficient calories to meet metabolic demands. Intuitively, investigators, nutritionists, and clinicians have pursued the goal of providing high-calorie nutrition support, believing that this would improve outcomes. There is little evidence, however, that meeting caloric goals is of significant benefit. In fact, accumulating data suggest that feeding patients below previously described caloric goals is associated with better outcomes, including decreases in hospital stay, ventilator dependence, use of antibiotics, and even mortality. This suggests that permissive underfeeding could replace the paradigm of meeting measured caloric goals. Prospective evidence to support adoption of permissive underfeeding is lacking, however. Appropriate clinical studies are necessary to prove its safety and efficacy.
ISSN:1052-5157
DOI:10.1016/j.giec.2007.07.004